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Reversible Malignant Hypertension and Azotemia Due to Urethral Stricture

Reversible Malignant Hypertension and Azotemia Due to Urethral Stricture Abstract A previously normotensive 24-year-old black man developed malignant hypertension and azotemia. The patient was found to have bladder outlet obstruction due to urethral stricture. Transurethral dilation resulted in brisk improvement in renal function and rapid lowering of blood pressure in association with minimal diuresis. On follow-up one year later, while he was not receiving medications, the blood pressure was 120/70 mm Hg and the creatinine clearance was 150 ml/min. A kidney biopsy specimen showed minimal residual pathologic abnormalities in the renal arteries and arterioles. The renin-angiotensin system was probably involved in the maintenance of the hypertension, in view of the elevated peripheral plasma renin activity on admission. This represents a rare case of hypertension due to urethral stricture. Despite rapid progression to azotemic malignant hypertension, urethral dilation restored the blood pressure and renal function to normal. (Arch Intern Med 137:370-372, 1977) References 1. Garret J, Poise SL, Morror JW: Ureteral obstruction and hypertension . Am J Med 49:271-273, 1970.Crossref 2. Belman AB, Knapp KA, Simon NM: Renalpressor hypertension secondary to unilateral hydronephrosis . N Engl J Med 278:1133, 1968.Crossref 3. Stockgit JR, Collins RD, Noakes RA, et al: Renal vein renin in various forms of renal hypertension . Lancet 1:1194-1198, 1972.Crossref 4. Squitieri AP, Ceccarelli FE, Wurster JC: Hypertension with elevated renal vein renins secondary to ureteropelvic junction obstruction . J Urol 111:284-287, 1974. 5. Palmer JM, Zweiman FG, Assaykeen TA: Hypertension, hydronephrosis and normal plasma renin . N Engl J Med 383:1032-1033, 1970.Crossref 6. Davis RS, Manning JA, Branch GL, et al: Renovascular hypertension secondary to hydronephrosis in a solitary kidney . J Urol 110:724-727, 1973. 7. Vaughan ED Jr, Buhler FR, Laragh JH: Normal renin secretion in hypertensive patients with primarily unilateral chronic hydronephrosis . J Urol 112:153-156, 1974. 8. McCormack LJ, Beland JE, Schneckloth RE, et al: Effects of antihypertensive treatment on the evaluation of the renal lesions in malignant nephrosclerosis . Am J Pathol 34:1011-1021, 1958. 9. Pickering G: Reversibility of malignant hypertension: Follow-up of three cases . Lancet 1:413-418, 1971.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Reversible Malignant Hypertension and Azotemia Due to Urethral Stricture

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References (9)

Publisher
American Medical Association
Copyright
Copyright © 1977 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1977.03630150068019
Publisher site
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Abstract

Abstract A previously normotensive 24-year-old black man developed malignant hypertension and azotemia. The patient was found to have bladder outlet obstruction due to urethral stricture. Transurethral dilation resulted in brisk improvement in renal function and rapid lowering of blood pressure in association with minimal diuresis. On follow-up one year later, while he was not receiving medications, the blood pressure was 120/70 mm Hg and the creatinine clearance was 150 ml/min. A kidney biopsy specimen showed minimal residual pathologic abnormalities in the renal arteries and arterioles. The renin-angiotensin system was probably involved in the maintenance of the hypertension, in view of the elevated peripheral plasma renin activity on admission. This represents a rare case of hypertension due to urethral stricture. Despite rapid progression to azotemic malignant hypertension, urethral dilation restored the blood pressure and renal function to normal. (Arch Intern Med 137:370-372, 1977) References 1. Garret J, Poise SL, Morror JW: Ureteral obstruction and hypertension . Am J Med 49:271-273, 1970.Crossref 2. Belman AB, Knapp KA, Simon NM: Renalpressor hypertension secondary to unilateral hydronephrosis . N Engl J Med 278:1133, 1968.Crossref 3. Stockgit JR, Collins RD, Noakes RA, et al: Renal vein renin in various forms of renal hypertension . Lancet 1:1194-1198, 1972.Crossref 4. Squitieri AP, Ceccarelli FE, Wurster JC: Hypertension with elevated renal vein renins secondary to ureteropelvic junction obstruction . J Urol 111:284-287, 1974. 5. Palmer JM, Zweiman FG, Assaykeen TA: Hypertension, hydronephrosis and normal plasma renin . N Engl J Med 383:1032-1033, 1970.Crossref 6. Davis RS, Manning JA, Branch GL, et al: Renovascular hypertension secondary to hydronephrosis in a solitary kidney . J Urol 110:724-727, 1973. 7. Vaughan ED Jr, Buhler FR, Laragh JH: Normal renin secretion in hypertensive patients with primarily unilateral chronic hydronephrosis . J Urol 112:153-156, 1974. 8. McCormack LJ, Beland JE, Schneckloth RE, et al: Effects of antihypertensive treatment on the evaluation of the renal lesions in malignant nephrosclerosis . Am J Pathol 34:1011-1021, 1958. 9. Pickering G: Reversibility of malignant hypertension: Follow-up of three cases . Lancet 1:413-418, 1971.Crossref

Journal

Archives of Internal Medicine – American Medical Association

Published: Mar 1, 1977

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