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Case Reports
. 2013 Mar;28(3):478-81.
doi: 10.1007/s11606-012-2183-5. Epub 2012 Aug 10.

Hypertension and hydronephrosis: rapid resolution of high blood pressure following relief of bilateral ureteric obstruction

Anil Chalisey  1 , Mahzuz Karim
Affiliations
Case Reports

Hypertension and hydronephrosis: rapid resolution of high blood pressure following relief of bilateral ureteric obstruction

Anil Chalisey et al. J Gen Intern Med. 2013 Mar.

Abstract

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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Figures

Figure 1.
Figure 1.
Contrast-enhanced magnetic resonance scan demonstrating bilateral hydronephrosis and hydroureter.
Figure 2.
Figure 2.
Blood pressure following insertion of bilateral nephrostomies.
Figure 3.
Figure 3.
The role of tubuloglomerular feedback in regulation of the glomerular filtration rate.
See this image and copyright information in PMC

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