アンジオテンシンIIアナローグテスト陰性であった腎血管性高血圧症の1例 (付)本テスト施行16例(腎性および腎血管性高血圧症例)の検討

Abstract

A case of renovascular hypertension initially diagnosed after injury was reported. The patient was a 52-year-old man who fell down from the second floor and suffered from multiple bone fractures and gross hematuria. Hypertemion (180/100 mmHg) and left non-visualizing kidney were found several weeks later, and referred to Our hospital 5 months after trauma with chief complaints of headache and sleeplessness. Peripheral plasma renin activity was high (3.72 ng/ml/hr), and the renal vein renin ratio was 3.97 (left/right). Severe stenotic lesion of the left renal artery was shown on renal angiogram. Angiotensin II Analogue test, however, did not show any decrease pattern of blood pressure as had been expected, even after furosemide load. Left nephrectomy waS performed and the patient became normotensive. We reviewed 16 cases of hypertension of renal origin in which Angiotensin II Analogue test was performed in our department. This case was the only case of renovascular hypertension with negative response even in the state of activated renin-angiotensin-aldosterone system.