Surgical treatment of renovascular hypertension

Abstract

Background: Renovascular hypertension is the commonest form of secondary hypertension. It occurs in less than 5 % of all hypertensive population. There are two forms of renovascular hypertension: Atherosclerotic and fibromuscular dysplasia. Renovascular hypertension is suspected when it develops suddenly in patients under 30 or over 55 years of age, or abruptly worsen in any patient. The aim was to evaluate the indications of surgical treatment of "renovascular hypertension". Methods: Twenty cases with renovascular hypertension were included. The main investigations were: Laboratory studies, Duplex ultrasound, Intravenous pyelogram, CT angiography, aortography and selective renal angiography. Indications for surgery were : complex disease of the renal artery, aneurysm, accessory renal arteries, fibromuscular dysplasia and partial damaged of one kidney. Also, atherosclerotic stenosis of the renal arteries and complete kidney damage. Results : According to the etiology, 20 patients were divided into two groups : Group 1(Below 30 years)(Fibromuscular dysplasia group)which included 14 patients, (100.0%) were females, their age ranged from 18 to years with the mean±SD (24.7±3.5).Group 2(Above55 years)(Atherosclerotic group) which included 6 patients, their age ranged from 55 to 68 years with the mean±SD(62 ±4.1), 5(83.3%)were males and 1(16.7%) was female. Renal artery bypass graft was done for 15 cases, endarterectomy in 2 cases, endarterectomy with patch graft in two cases and nephrectomy in one case. Control of hypertension was successful in 17 cases, partial control of 2 cases, while the blood pressure still high in case of nephrectomy. No mortality in both groups within 6 months follow up period. Conclusions : Surgical treatment for renovascular hypertension is mandatory for complex disease of the renal artery, aneurysms and failure of endovascular procedures. Nephrectomy is the treatment of choice for damaged kidney.

Effect of season and pregnancy on minerals serum variations of local rabbits in Tiaret, Algeria

“…Abdel-Samee [15] confirmed that exposure of farm animals to heat stress in accompanied by a decrease in cholesterol concentration. However, Salem [16] reported that serum cholesterol concentration was significantly higher during summer than in winter. The decline in cholesterol concentration during exposure to heat stress may be due to the increase in total body water or to the decrease in acetate concentration which is the main precursor for the synthesis of cholesterol [17,18].…”