title: Unilateral stent implantation for renal function in bilateral atherosclerotic renovascular hypertension--a case report.
abstract: Renal artery stenting improves or preserves renal function in patients with bilateral renovascular disease and chronic renal insufficiency. An 80-year-old male was admitted to the hospital for elevated blood pressure accompanied by congestive heart failure. He had renal insufficiency and severe hypertension secondary to bilateral atherosclerotic renal artery stenosis. Unilateral renal artery stenting in the left kidney resulted in the recovery of renal function, whereas renal artery stenting in the right kidney was technically difficult due to a tortuous aorta. After the left unilateral stent implantation, the serum creatinine concentration decreased from 2.0 to 1.3 mg/dL, and control of his blood pressure required fewer antihypertensive drugs, namely a calcium antagonist, an angiotensin-converting enzyme inhibitor, and diuretics. Fifteen months after stenting, renal scintigraphy demonstrated improved function of the right kidney, despite severe renal artery stenosis, as well as improved function of the left kidney. Renal angioplasty or stenting should be attempted in bilateral atherosclerotic renovascular hypertension with renal insufficiency, even though it may only be successful unilaterally.
authors.affiliation: First Department of Internal Medicine, School of Medicine, Kanazawa University, Japan. takakuwa@medf.m.kanazawa-u.ac.jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takakuwa
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Shimizu
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Izumiya
authors.forename: Tamayo
authors.initials: T
authors.lastname: Kato
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Yokoyama
authors.forename: Ken-ichi
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Osamu
authors.initials: O
authors.lastname: Matsui
authors.forename: Takuyuki
authors.initials: T
authors.lastname: Ise
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D006333:Heart Failure / Q000150:complications; D006801:Humans; D006978:Hypertension, Renovascular / Q000188:drug therapy / Q000209:etiology / Q000628:therapy*; D008297:Male; D011877:Radionuclide Imaging; D012078:Renal Artery Obstruction / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D015607:Stents
chemical_list: D000959:Antihypertensive Agents