Abstract
A case of renovascular hypertension is presented with special emphasis on segmental hypoperfusion resulting from single vessel stenosis in the presence of bilateral duplex renal arteries. A forty-year-old male patient presenting with progressive elevation of blood pressure and proteinuria was admitted to our hospital for further evaluation. The elevation of plasma renin activity (PRA) was confirmed only after two-hour standing or under angiotensin converting enzyme inhibition with captopril. PRA obtained from the left renal vein was significantly higher than that from the right renal vein, and the angiogram disclosed bilateral duplex renal arteries and stenosis of 90% or more at the proximal portion in the left upper renal artery. Successful percutaneous transluminal renal angioplasty (PTRA) to the affected single renal artery resulted in normalization of the blood pressure and renin-angiotensin-aldosterone axis. This is the first clinical demonstration of renovascular hypertension resulting from segmental hypoperfusion of a unilateral kidney with lateralizing renal venous renin determination, that was successfully treated by revascularization. (Hypertens Res 1992; 15: 177-180)
