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Renovascular hypertension with massive proteinuria
H Ogata1, N Ishiyama, K Hamabe
1Department of Internal Medicine, Sapporo Shakai-Hoken General Hospital.
Internal Medicine (Tokyo, Japan)
|July 1, 1996
Summary
Renovascular hypertension and massive proteinuria in a 65-year-old woman were resolved after left nephrectomy. This case highlights the impact of renal artery occlusion on blood pressure and protein excretion.
Area of Science:
- Nephrology
- Cardiovascular Medicine
- Endocrinology
Background:
- Presents a case of a 65-year-old woman with severe renovascular hypertension and massive proteinuria.
- Characterized by significant urinary protein excretion (3-5 g/day) and hypokalemia (serum potassium 2.9 mEq/l).
Observation:
- Elevated plasma renin activity and plasma aldosterone concentration were noted.
- Imaging revealed left kidney atrophy, a non-functioning left kidney on renogram, and complete occlusion of the left renal artery at its origin.
Findings:
- Surgical intervention via left nephrectomy led to the normalization of both blood pressure and urinary protein levels.
- The patient's hypertension and proteinuria were directly linked to the compromised left renal artery.
Implications:
- Suggests a significant endocrinological role of the affected kidney in causing massive proteinuria.
- Demonstrates the efficacy of nephrectomy in treating severe renovascular hypertension and associated proteinuria.
- Underscores the importance of evaluating renal artery patency in patients with unexplained hypertension and proteinuria.