4.2 Article

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

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INTERNAL MEDICINE
卷 60, 期 2, 页码 287-292

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JAPAN SOC INTERNAL MEDICINE
DOI: 10.2169/internalmedicine.5290-20

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renal artery stenosis; renovascular hypertension; renin-angiotensin system inhibitors; atherosclerotic renovascular disease; diffusion-weighted MRI

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Timely angioplasty can be beneficial for select patients, even with an atrophic kidney and total occlusion, especially in cases with hypertension deterioration within six months and collateral perfusion to the affected kidney.
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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