Percutaneous Transluminal Angioplastyを試みた単腎患者の腎血管性高血圧症の1例

Abstract

The patient was a 18-year-old woman. Past history included right nephrectomy for right congenital hydronephrosis when she was an infant of 40 days. On examination, her blood pressure was 220/140 mmHg, and plasma renin activity was 4.2 ng/ml/hr. The selective renal arteriogram showed fibromuscular dysplasia of the left main renal artery, and a diagnosis of renovascular hypertension in the solitary kidney with an aberrant artery was made. Treatment with orally-active inhibitor of angiotensin I converting enzyme, Captopril, was started. Her blood pressure became normal after oral administration of Captopril, but her renal function deteriorated. Therefore, percutaneous transluminal angioplasty was performed twice resulting in effective dilatation of the stenotic portion of the left main renal artery. Thereafter, her blood pressure fluctuated between 170/120 and 140/70 mmHg. Eight months later, her blood pressure is now being controlled with mild antihypertensive treatment.