title: A young patient with a family history of hypertension.
abstract: The evaluation of causes of hypertension in young adults with a family history of hypertension needs to be methodical to identify potentially treatable causes. Renal- and renovascular imaging and measurement of plasma aldosterone and plasma renin activity are at the core of this evaluation in most patients. Pertinent aspects of hypertension in autosomal dominant polycystic kidney disease are discussed with a focus on the role of the endothelium in mediating early hypertension and a review of treatment strategies. Finally, the possibility that autosomal dominant polycystic kidney disease and primary aldosteronism are connected beyond coincidence is explored; evidence to support it is scant, although there is a likely role for aldosterone excess and the resultant hypokalemia in promoting cyst growth.
authors.affiliation: Section of Nephrology, Yale University School of Medicine, New Haven, Connecticut aldo.peixoto@yale.edu.
authors.forename: Aldo J
authors.initials: AJ
authors.lastname: Peixoto
mesh_terms: D000236:Adenoma / Q000150:complications*; D000310:Adrenal Gland Neoplasms / Q000150:complications*; D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use; D018450:Disease Progression; D006801:Humans; D006929:Hyperaldosteronism / Q000209:etiology; D006973:Hypertension / Q000188:drug therapy* / Q000209:etiology*; D007008:Hypokalemia / Q000139:chemically induced; D008297:Male; D008487:Medical History Taking; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use; D016891:Polycystic Kidney, Autosomal Dominant / Q000150:complications*
chemical_list: D000959:Antihypertensive Agents; D000451:Mineralocorticoid Receptor Antagonists
keywords: aldosterone; genetic renal disease; hyperaldosteronism; hypertension; polycystic kidney disease
references.citation: J Hypertens. 2007 Jul;25(7):1443-50
references.pmid: 17563567
references.citation: J Clin Endocrinol Metab. 2008 Sep;93(9):3266-81
references.pmid: 18552288
references.citation: Nephrol Dial Transplant. 2003 Nov;18(11):2314-20
references.pmid: 14551359
references.citation: Kidney Int. 2012 May;81(9):919-24
references.pmid: 22297678
references.citation: Endocr J. 1996 Jun;43(3):261-8
references.pmid: 8886619
references.citation: Nefrologia. 2010;30(5):567-72
references.pmid: 20882096
references.citation: N Engl J Med. 2013 Nov 14;369(20):1892-903
references.pmid: 24206457
references.citation: J Am Soc Nephrol. 2011 Dec;22(12):2313-21
references.pmid: 22025630
references.citation: Eur J Pediatr. 2012 Oct;171(10):1433-9
references.pmid: 21404100
references.citation: Am J Kidney Dis. 2011 Jun;57(6):856-62
references.pmid: 21458899
references.citation: BMJ. 2012 Jan 13;344:e181
references.pmid: 22246269
references.citation: Clin J Am Soc Nephrol. 2012 Nov;7(11):1770-6
references.pmid: 22935847
references.citation: Adv Chronic Kidney Dis. 2010 Mar;17(2):153-63
references.pmid: 20219618
references.citation: Curr Hypertens Rev. 2013 Feb;9(1):32-6
references.pmid: 23971642
references.citation: Am J Kidney Dis. 2000 Mar;35(3):427-32
references.pmid: 10692268
references.citation: J Ren Nutr. 2002 Jul;12(3):151-9
references.pmid: 12105812
references.citation: Nephrol Dial Transplant. 1997 Oct;12(10):2075-80
references.pmid: 9351068
references.citation: Am J Pathol. 1976 Feb;82(2):373-80
references.pmid: 1251891
references.citation: J Am Soc Nephrol. 1995 Jun;5(12):2037-47
references.pmid: 7579052
references.citation: Clin J Am Soc Nephrol. 2011 Mar;6(3):640-7
references.pmid: 21088290
references.citation: Am J Physiol. 1992 Apr;262(4 Pt 2):F656-67
references.pmid: 1566879
references.citation: Clin J Am Soc Nephrol. 2014 Feb;9(2):406-15
references.pmid: 24370765
references.citation: Int Urol Nephrol. 2007;39(1):233-8
references.pmid: 17031504
references.citation: Br J Exp Pathol. 1960 Apr;41:140-9
references.pmid: 13797797
references.citation: Am J Nephrol. 2000 May-Jun;20(3):193-200
references.pmid: 10878400
references.citation: Pediatr Nephrol. 1994 Apr;8(2):186-9
references.pmid: 8018497
references.citation: Pediatr Nephrol. 1997 Jun;11(3):343-6
references.pmid: 9203188
references.citation: Kidney Int. 1992 May;41(5):1311-9
references.pmid: 1614046
references.citation: J Clin Hypertens (Greenwich). 2012 May;14(5):316-21
references.pmid: 22533658
references.citation: Am J Nephrol. 2007;27(3):240-6
references.pmid: 17389784
references.citation: J Hypertens. 2013 Jul;31(7):1281-357
references.pmid: 23817082
references.citation: Am J Nephrol. 1998;18(5):391-8
references.pmid: 9730562
references.citation: Nat Rev Nephrol. 2011 Jan;7(1):55-60
references.pmid: 21102541
references.citation: J Am Soc Nephrol. 2002 Jul;13(7):1733-9
references.pmid: 12089368
references.citation: Kidney Int. 2001 May;59(5):1654-62
references.pmid: 11318935
references.citation: J Am Coll Cardiol. 2010 Mar 30;55(13):1318-27
references.pmid: 20338492
references.citation: MMWR Morb Mortal Wkly Rep. 2011 Feb 4;60(4):103-8
references.pmid: 21293325
references.citation: Curr Hypertens Rep. 2013 Apr;15(2):89-94
references.pmid: 23344662
references.citation: Circulation. 2007 Sep 25;116(13):1488-96
references.pmid: 17846287
references.citation: Nephrol Dial Transplant. 2008 Feb;23(2):573-9
references.pmid: 17984104
references.citation: N Engl J Med. 1990 Feb 8;322(6):345-51
references.pmid: 2405267
references.citation: Ann Intern Med. 2005 Mar 1;142(5):342-51
references.pmid: 15738453
references.citation: Clin J Am Soc Nephrol. 2009 Mar;4(3):656-64
references.pmid: 19261815
references.citation: Nephrol Dial Transplant. 2014 Dec;29(12):2194-201
references.pmid: 24463189
references.citation: J Am Soc Nephrol. 1999 May;10(5):1020-6
references.pmid: 10232688
references.citation: Nephron Clin Pract. 2005;99(1):c18-23
references.pmid: 15637459
references.citation: Int J Vasc Med. 2011;2011:376281
references.pmid: 21748021
references.citation: Curr Hypertens Rev. 2013 Feb;9(1):37-43
references.pmid: 23971643
references.citation: Am J Nephrol. 2001 Mar-Apr;21(2):98-103
references.pmid: 11359016
references.citation: Science. 1967 Oct 27;158(3800):494-6
references.pmid: 6048105
references.citation: J Am Soc Nephrol. 2007 Feb;18(2):560-9
references.pmid: 17202412
references.citation: J Hum Hypertens. 2007 May;21(5):393-400
references.pmid: 17330059
references.citation: Kidney Int. 2003 Nov;64(5):1792-9
references.pmid: 14531813
references.citation: Blood Press Monit. 2011 Apr;16(2):47-54
references.pmid: 21415814
references.citation: J Renin Angiotensin Aldosterone Syst. 2013 Jun;14(2):167-73
references.pmid: 22791703
references.citation: Ann Surg. 2008 Mar;247(3):511-8
references.pmid: 18376197
references.citation: Lancet. 2008 Apr 26;371(9622):1453-63
references.pmid: 18440428
references.citation: J Am Soc Nephrol. 2003 Feb;14(2):367-76
references.pmid: 12538737
references.citation: Kidney Int. 2003 Oct;64(4):1381-8
references.pmid: 12969157
references.citation: Circulation. 2011 Mar 15;123(10):1098-107
references.pmid: 21357827
references.citation: Curr Hypertens Rep. 2002 Dec;4(6):439-44
references.pmid: 12419172