Treatment of Refractory Hypertension with Timely Angioplasty in Total Renal Artery Occlusion with Atrophic Kidney

Yuri Sasaki; Eikan Mishima; Koichi Kikuchi; Takafumi Toyohara; Takehiro Suzuki; Hideki Ota; Kazumasa Seiji; Mariko Miyazaki; Hideo Harigae; Sadayoshi Ito; Kei Takase; Takaaki Abe

doi:10.2169/internalmedicine.5290-20

CASE REPORTS

Treatment of Refractory Hypertension with Timely Angioplasty in Total Renal Artery Occlusion with Atrophic Kidney

Yuri Sasaki, Eikan Mishima, Koichi Kikuchi, Takafumi Toyohara, Takehiro Suzuki, Hideki Ota, Kazumasa Seiji, Mariko Miyazaki, Hideo Harigae, Sadayoshi Ito, Kei Takase, Takaaki Abe

Author information

Yuri Sasaki
Tohoku University School of Medicine, Japan
Eikan Mishima
Division of Nephrology, Endocrinology, and Vascular Medicine, Tohoku University Graduate School of Medicine, Japan
Koichi Kikuchi
Division of Nephrology, Endocrinology, and Vascular Medicine, Tohoku University Graduate School of Medicine, Japan
Takafumi Toyohara
Division of Nephrology, Endocrinology, and Vascular Medicine, Tohoku University Graduate School of Medicine, Japan
Takehiro Suzuki
Division of Nephrology, Endocrinology, and Vascular Medicine, Tohoku University Graduate School of Medicine, Japan
Hideki Ota
Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Japan
Kazumasa Seiji
Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Japan
Mariko Miyazaki
Division of Nephrology, Endocrinology, and Vascular Medicine, Tohoku University Graduate School of Medicine, Japan
Hideo Harigae
Division of Nephrology, Endocrinology, and Vascular Medicine, Tohoku University Graduate School of Medicine, Japan
Department of Hematology and Rheumatology, Tohoku University Graduate School of Medicine, Japan
Sadayoshi Ito
Division of Nephrology, Endocrinology, and Vascular Medicine, Tohoku University Graduate School of Medicine, Japan
Department of Medicine, Katta Public General Hospital, Japan
Kei Takase
Department of Diagnostic Radiology, Tohoku University Graduate School of Medicine, Japan
Takaaki Abe
Division of Nephrology, Endocrinology, and Vascular Medicine, Tohoku University Graduate School of Medicine, Japan
Division of Medical Science, Tohoku University Graduate School of Biomedical Engineering, Japan
Department of Clinical Biology and Hormonal Regulation, Tohoku University Graduate School of Medicine, Japan

Keywords: renal artery stenosis, renovascular hypertension, renin-angiotensin system inhibitors, atherosclerotic renovascular disease, diffusion-weighted MRI

JOURNAL OPEN ACCESS

2021 Volume 60 Issue 2 Pages 287-292

DOI https://doi.org/10.2169/internalmedicine.5290-20

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Abstract

Angioplasty for cases of chronic total occlusion of renal artery with/without atrophic kidney is generally not recommended. We herein report a 57-year-old man who presented with renin-mediated refractory hypertension caused by occlusion of a unilateral renal artery leading to kidney atrophy (length: 69 mm). Angioplasty favorably achieved blood pressure control with normalized renin secretion and enlargement of the atrophic kidney to 85 mm. Timely angioplasty can be beneficial in select patients, even with an atrophic kidney and total occlusion, especially in cases with deterioration of hypertension within six months and the presence of collateral perfusion to the affected kidney.

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