Proximal Renal Artery Stenosis Presenting as Uncontrolled Hypertension

Abstract

Presentation: We present a case of 50-year-old lady who present with 1-month history of uncontrolled hypertension.

Diagnosis: Magnetic resonance angiography showed stenosis of the left renal artery just beyond the ostium extending over approximately 7mm in length. Computed tomography angiography show focal narrowing of the proximal renal artery just distal to vessel origin, approximately 60% stenosis.

Treatment: Anti-hypertensive medication was initiated in the ward. She was referred to vascular surgeon for renal bypass.

Discussion: Renal artery stenosis is common cause of hypertension but may go unrecognised. The focus of this case is on the evaluation and necessity for a complete evaluation of the patient who is presenting with uncontrolled hypertension. To rule out renal artery stenosis, patient should be examined using CT-angiography or, if possible, arteriography.