Hypertension with elevated renal vein renin secondary to unilateral hydronephrosis

A case of hypertension secondary to unilateral hydronephrosis is reported. Renin levels were elevated in peripheral veins and in the renal vein draining the affected kidney. An infusion of angiotensin II analogue resulted in a decrease in blood pressure. After nephrectomy, blood pressure and peripheral plasma renin activity returned to normal. Renal vein renin and angiotensin II analogue studies were useful in the diagnosis and evaluation of curability by surgery in this case.