title: [Accelerated arterial hypertension in a young male].
abstract: Hypertensive crises are situations when arterial hypertension shows its immediate damaging potential, and in such circumstance, antihypertensive therapy provides its life-saving effectiveness. Among these situations are hypertensive emergencies, hypertensive urgencies, hypertensive encephalopathy, and also accelerated-malignant hypertension characterised by the presence of grade 3 or grade 4 Keith-Wagener retinopathy and numerous complications (acute renal failure, heart failure, haemorrhagic brain stroke or acute coronary events). Despite of antihypertensive therapy, the mortality rate of accelerated-malignant hypertension is about 25% after the 5th year. We present the case of a thirty-three years old male, with a five-year history of non-treated hypertension, who develops accelerated- hypertension with heart failure, microangiopathic haemolytic anaemia and renal failure that requires renal replacement therapy. After a strict control of blood pressure; initially using parenteral agents such as Solinitrin and Urapidil, followed by angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, beta-adrenergic receptor blockers, calcium channel blockers and Hydralazine, the patient partially recovers his renal function, resulting in the withdrawal of haemodialysis.
authors.affiliation: Servicio de Nefrología, Hospital del Mar, Barcelona. 92844@imas.imim.es
authors.forename: M J
authors.initials: MJ
authors.lastname: Soler
authors.forename: J
authors.initials: J
authors.lastname: Parrilla
authors.forename: S
authors.initials: S
authors.lastname: Vázquez González
authors.forename: A
authors.initials: A
authors.lastname: Orfila
authors.forename: J
authors.initials: J
authors.lastname: Lloveras
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology* / Q000628:therapy; D000328:Adult; D000743:Anemia, Hemolytic / Q000209:etiology; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D006333:Heart Failure / Q000209:etiology; D006417:Hematuria / Q000209:etiology; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications; D006974:Hypertension, Malignant / Q000150:complications* / Q000188:drug therapy; D033461:Hyperuricemia / Q000150:complications; D008297:Male; D009765:Obesity / Q000150:complications; D010211:Papilledema / Q000209:etiology; D012008:Recurrence; D006435:Renal Dialysis; D012166:Retinal Hemorrhage / Q000209:etiology; D016312:Treatment Refusal
chemical_list: D000959:Antihypertensive Agents