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Please use this identifier to cite or link to this item: http://hdl.handle.net/20.500.12001/2166

 
Title :[原著]右萎縮腎,左腎動脈狭窄による高血圧症の1例
Title alternative :A case of hypertension with right sided contracted kidney and left sided renal artery stenosis
Authors :大浦, 孝
与那嶺, 毅
佐久本, 政紀
具志堅, 政道
伊礼, 基治
三村, 悟郎
知名, 孝明
小山, 雄三
大澤, 炯
Authors alternative :Ooura, Takashi
Yonamine, Tsuyoshi
Sakumoto, Seiki
Gushiken, Masamichi
Irei, Motoharu
Mimura, Goro
China, Takaaki
Koyama, Yuzo
Osawa, Akira
Authors affiliation :琉球大学保健学部附属病院帯2内科
琉球大学保健学部附属病院第1内科
琉球大学保健学部附属病院放射線科
琉球大学保健学部附属病院泌尿器科
Issue Date :1980
Publisher :琉球大学保健学部
Type Local :雑誌掲載論文
Type (NII) :Journal Article
ISSN :0285-9270
Abstract :We reported a case of hypertension and discussed it's etiology. A 52-year-old female was admitted to our clinic for closer examination of hypertension discovered 7 years ago during a mass-examination. Thereafter she took drugs occationally but complained of occational headache and palpitation. She noticed facial edema after overworking but there were no episodes of urinary tract infection. In physical examination, her B.P. was 190/130mmHg, face was slightly puffy and cardiac dullness was enlarged, but there was no abdominal bruit and no edema in legs. In laboratory data, proteinuria was negative but there was many WBC in the urinary sediment. Renal function was almost normal; psp in 15min. was 25.5%; creatinine clearance was 101.2ml/min. Peripheral plasma renm activity was as low as 0.35ng/ml/hr and did not responded to furosemide load and standing position, plasma aldosterone was slightly elevated at 185.5pg/ml and 3 fractions of urinary catecholamine were within normal limits. IVP revealed a right sided contracted kidney, dilatation of the pelvis and deformities of the calyx, but the left sided kidney was almost normal. Angiography revealed left sided renal artery stenoses but no stenosis of the right sided renal artery but the right sided main renal artery and peripheral arteries were very narrow. For examination of the cause of the right sided contracted kidney, we performed a cystography, which revealed a right sided vesicoureteric reflux (VUR). We then suspected this was the cause of right sided contracted kidney. Indivisual renal function test was done but provided unreasonable data, so we considered this an improper test in this case. We performed angiotensin II analogue infusion test for differential diagnosis of hypertension. There was no response to this test and we speculated there was no role of reninangiotensin system causing this hypertension. We began treatment with diuretica, and diuresis occured and facial edema disappeared. B.P. was controlled at a good level.
Rights :琉球医学会
URI :http://hdl.handle.net/20.500.12001/2166
Citation :琉球大学保健学医学雑誌=Ryukyu University Journal of Health Sciences and Medicine Vol.3 no.1 p.36 -44
Appears in Collections:Ryukyu University Journal of Health Sciences and Medicine

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