Posttraumatic renovascular Hypertension after occult renal injury.
Hypertension secondary to renal injury is an unusual problem, but one that occurs with some frequency in an active trauma unit.
The incidence and management of posttraumatic renovascular hypertension at our Level I trauma center was reviewed.
A retrospective review of a trauma database was performed on patients treated by our trauma service between 1977 and 1996.
Seven patients were identified who developed arterial hypertension as a direct result of a renal injury.
All of the patients sustained multiple injuries, with five requiring celiotomy to control bleeding.
Renal injuries were occult, and there was no compelling reason to suspect injury to the kidney.
No patient had a history of hypertension or elevated arterial pressure on admission ; however, sustained arterial hypertension was noted within 2 weeks to 8 months of injury.
Arteriography was positive in all seven patients, with findings that included lacerations of the main renal artery, its major branches, or intrarenal constriction of the renal artery (presumably from scarring).
Renal-vein renin assays localized to the injured kidney in six patients.
Treatment included nephrectomy in four cases, revascularization in one case, and medical management in two cases.
All of the patients treated operatively had prompt relief of their hypertension.
The two patients treated soley by medical therapy had prompt, durable control of their arterial pressure with a single medication. (...)
Mots-clés Pascal : Traumatisme, Rein, Complication, Hypertension artérielle, Rein pathologie, Symptomatologie, Diagnostic, Homme, Traitement, Epidémiologie, Incidence, Appareil urinaire pathologie, Appareil circulatoire pathologie
Mots-clés Pascal anglais : Trauma, Kidney, Complication, Hypertension, Kidney disease, Symptomatology, Diagnosis, Human, Treatment, Epidemiology, Incidence, Urinary system disease, Cardiovascular disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0369428
Code Inist : 002B16E. Création : 25/01/1999.