Plasma renin activity revealed renal artery stenosis concealed by aneurysms.
We describe a case of renovascular hypertension with renal artery stenosis concealed by aneurysms. Arteriography demonstrated no apparent renal artery stenosis, but did reveal aneurysms on the left renal artery. Captopril-loaded renoscintigraphy could not detect disturbed renal perfusion. High basal and exaggerated plasma renin activity after captopril administration were the only clues indicating renovascular hypertension. A reduction of the systemic blood pressure and normalized plasma renin activity after resection of the aneurysms confirmed preoperative renovascular hypertension. Fibromuscular dysplasia was an underlying cause of the arterial deformity. In cases of hypertension accompanied by renal artery aneurysms, the captopril-challenge test can be a useful tool to detect renal artery stenosis concealed by the aneurysms.
Tanemoto
Masayuki
M
Division of Nephrology, Hypertension and Endocrinology, Department of Medicine, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan. mtanemoto-tky@umin.ac.jp
Abe
Takaaki
T
Satoh
Fumitoshi
F
Ito
Sadayoshi
S
D000328:Adult; D000783:Aneurysm / Q000097:blood* / Q000150:complications / Q000175:diagnosis*; D001157:Arterial Occlusive Diseases / Q000097:blood* / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D008297:Male; D012077:Renal Artery; D012083:Renin / Q000097:blood*
D012083:Renin