Renal-Pressor Hypertension Secondary to Unilateral Hydronephrosis

Belman, A. Barry; Kropp, Kenneth Α.; Simon, Norman

doi:10.1056/nejm196805232782101

Cited by 94 publications

(23 citation statements)

References 11 publications

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“…Secondary hypertension occurring as a consequence of hydronephrosis has been described in a small number of animal models 1 and clinical reports. [2][3][4][5] Interestingly, based upon the limited number of cases, unilateral hydronephrosis appears to be sufficient to cause hypertension. 2,4,5 The presence of a normal contralateral kidney may not be adequate to mitigate the effect of the hydronephrosis.…”

Section: Discussionmentioning

confidence: 99%

“…[2][3][4][5] Interestingly, based upon the limited number of cases, unilateral hydronephrosis appears to be sufficient to cause hypertension. 2,4,5 The presence of a normal contralateral kidney may not be adequate to mitigate the effect of the hydronephrosis. Some authors describe resolution of hypertension following removal of the affected kidney, 5 while others show that relief of obstruction may also lead to normalisation of blood pressure.…”

Section: Discussionmentioning

confidence: 99%

“…Some authors describe resolution of hypertension following removal of the affected kidney, 5 while others show that relief of obstruction may also lead to normalisation of blood pressure. 2,3 It therefore appears that the intra-renal mechanism leading to the pressor effect is reversible. Increased activity of both the TGF system and RAA axis are thought to play an important role in this process.…”

Section: Discussionmentioning

confidence: 99%

“…In animal studies and clinical reports on hydronephrosis, peripheral plasma renin activity has been shown to be elevated. 1,2,5 In cases of hypertension and unilateral hydronephrosis, selective renal vein sampling generally shows elevated renin secretion from the affected kidney and suppressed levels from the contralateral side. 5 High preoperative plasma renin levels are predictive of improvement in blood pressure following surgery in hypertensive hydronephrotic patients.…”

Section: Discussionmentioning

confidence: 99%

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Hypertension and Hydronephrosis: Rapid Resolution of High Blood Pressure Following Relief of Bilateral Ureteric Obstruction

Chalisey

Karim

2012

J GEN INTERN MED

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Hypertension secondary to hydronephrosis is not commonly reported in the medical literature. Tubuloglomerular feedback and the renin-angiotensin-aldosterone axis are thought to mediate this process. We describe a patient presenting with acute kidney injury and bilateral hydronephrosis secondary to pelvic malignancy in which peripheral venous renin and aldosterone were elevated. Her blood pressure improved rapidly following insertion of bilateral nephrostomies. The speed of resolution of hypertension following relief of obstruction suggests that humorally mediated vasoconstriction can play an important role in the mechanism by which hydronephrosis causes hypertension. We also discuss other causes of renal parenchymal compression that may lead to the development of hypertension.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Hypertension and Hydronephrosis: Rapid Resolution of High Blood Pressure Following Relief of Bilateral Ureteric Obstruction

Chalisey

Karim

2012

J GEN INTERN MED

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“…Hypertension accompanying unilateral urinary tract obstruction may be associated with increased renal vein renin levels in the obstructed kidney, and relief of obstruction has been observed to cause a decline of renal vein renin to normal, with normalization of blood pressure (Belman et al, 1968). Weidman et al (1977) studied six patients before and after surgical treatment for unilateral ureteric obstruction, and noted a correlation between the post-operative blood pressure decline and a fall in plasma renin levels.…”

Section: Discussionmentioning

confidence: 99%

Secondary hypertension accompanying high pressure chronic retention

Ghose¹,

Birks²

1985

Postgraduate Medical Journal

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Summary:Two middle-aged men were referred for control of severe hypertension, presumed to be 'essential'. Late-onset enuresis, a small palpable bladder, and slight prostatic enlargement were elicited in one patient; history and examination were unremarkable in the other patient, apart from moderate prostatic enlargement. Intravenous urography revealed massive bilateral hydronephrosis with hydroureters in both patients. Surgical relief of retention was associated with post-obstructive diuresis and normalization of blood pressure, although recurrence of hypertension occurred later in one patient. These patients suffered from high pressure chronic retention, a syndrome characterized by impairment of renal function and hypertension. Surgical relief of retention was accompanied by prompt correction of hypertension, and gradual, sustained recovery of renal function.

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Reversible Malignant Hypertension and Azotemia Due to Urethral Stricture

Vincenti¹

1977

Arch Intern Med

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Renal-Pressor Hypertension Secondary to Unilateral Hydronephrosis

Cited by 94 publications

References 11 publications

Hypertension and Hydronephrosis: Rapid Resolution of High Blood Pressure Following Relief of Bilateral Ureteric Obstruction

Hypertension and Hydronephrosis: Rapid Resolution of High Blood Pressure Following Relief of Bilateral Ureteric Obstruction

Secondary hypertension accompanying high pressure chronic retention

Reversible Malignant Hypertension and Azotemia Due to Urethral Stricture

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