Renin participation in hypertension associated with unilateral hydronephrosis

Renin-mediated hypertension can occur with unilateral renal obstruction and hydronephrosis. Elevated peripheral plasma renin activity and a lateralizing renal vein renin relationship represent a hormonal pattern suspiciously suggestive of a renovascular etiology. We report a case of surgically corrected renin-mediated hypertension secondary to ureteropelvic junction obstruction. Hyperreninemia associated with acute unilateral hydronephrosis probably occurs transiently to initiate chronic hypertension sustained by more complex volume-vasoconstriction abnormalities. The participation of renin in this hypertension seems to be influenced by the duration of the obstruction, the presence or absence of a contralateral normal kidney and other intrarenal factors.