Uncontrolled hypertension and hyperreninemia after hemorrhage in a patient with end-stage renal disease and acquired renal cysts

Acquired cystic kidney disease occurs in over 74% of patients with ESRD on hemodialysis for more than 4 yr. A variety of complications have been associated with these cysts including bleeding, lithiasis, infection, obstruction, and malignant transformation. An ESRD patient who developed accelerating...

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Bibliographic Details
Published in:Journal of the American Society of Nephrology 1994-07, Vol.5 (1), p.22-26
Main Authors: Bongu, S, Faubert, P F, Porush, J G, Gulmi, F
Format: Article
Language:English
Subjects:
Glomerulonephritis - complications
Glomerulonephritis - therapy
Hematoma - complications
Hematoma - surgery
Hemorrhage - complications
Humans
Hypertension, Renal - etiology
Ischemia - complications
Kidney - blood supply
Kidney Failure, Chronic - complications
Kidney Failure, Chronic - therapy
Male
Middle Aged
Nephrectomy
Polycystic Kidney Diseases - complications
Polycystic Kidney Diseases - physiopathology
Renal Dialysis - adverse effects
Renin - blood
Renin-Angiotensin System - physiology
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Summary:Acquired cystic kidney disease occurs in over 74% of patients with ESRD on hemodialysis for more than 4 yr. A variety of complications have been associated with these cysts including bleeding, lithiasis, infection, obstruction, and malignant transformation. An ESRD patient who developed accelerating hypertension secondary to an acute perinephric hematoma due to a bleeding-acquired renal cyst is described. The hypertension, which was refractory to aggressive drug therapy, was controlled only after the involved kidney was removed, after the demonstration of an elevated ipsilateral renal vein renin level. This is the first case reported in which worsening hypertension, apparently due to the "Page Kidney," developed as a complication of perinephric bleeding in an ESRD patient with acquired cystic kidney disease.
ISSN:1046-6673
1533-3450
DOI:10.1681/ASN.V5122