Attending rounds: A patient with accelerated hypertension and an atrophic kidney

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

This case represents an individual with accelerating hypertension and declining kidney function associated with atherosclerotic renal artery stenosis. Key features include loss of GFR (reaching stage V CKD) during intensified antihypertensive drug therapy including agents that block the renin-angiotensin system and failure to appreciate the extent to which moderate renal artery stenosis was affecting his better kidney. Interpretation of duplex ultrasound studies was complicated by a discrepancy between near-normal peak systolic velocities and markedly abnormal segmental arterial waveforms. It was essential to recognize that both kidneys were abnormal and focus on recovery of perfusion to the better of these kidneys. Successful revascularization of one kidney allowed major improvement in GFR and BP control.

Original languageEnglish (US)
Pages (from-to)1117-1123
Number of pages7
JournalClinical Journal of the American Society of Nephrology
Volume9
Issue number6
DOIs
StatePublished - 2014

Fingerprint

Teaching Rounds
Hypertension
Kidney
Renal Artery Obstruction
Renin-Angiotensin System
Antihypertensive Agents
Perfusion
Drug Therapy

ASJC Scopus subject areas

  • Nephrology
  • Transplantation
  • Epidemiology
  • Critical Care and Intensive Care Medicine

Cite this

@article{eca6cb5e49f94821a3c3e9eeebf8e320,
title = "Attending rounds: A patient with accelerated hypertension and an atrophic kidney",
abstract = "This case represents an individual with accelerating hypertension and declining kidney function associated with atherosclerotic renal artery stenosis. Key features include loss of GFR (reaching stage V CKD) during intensified antihypertensive drug therapy including agents that block the renin-angiotensin system and failure to appreciate the extent to which moderate renal artery stenosis was affecting his better kidney. Interpretation of duplex ultrasound studies was complicated by a discrepancy between near-normal peak systolic velocities and markedly abnormal segmental arterial waveforms. It was essential to recognize that both kidneys were abnormal and focus on recovery of perfusion to the better of these kidneys. Successful revascularization of one kidney allowed major improvement in GFR and BP control.",
author = "Textor, {Stephen C}",
year = "2014",
doi = "10.2215/CJN.09030813",
language = "English (US)",
volume = "9",
pages = "1117--1123",
journal = "Clinical Journal of the American Society of Nephrology",
issn = "1555-9041",
publisher = "American Society of Nephrology",
number = "6",

}

TY - JOUR

T1 - Attending rounds

T2 - A patient with accelerated hypertension and an atrophic kidney

AU - Textor, Stephen C

PY - 2014

Y1 - 2014

N2 - This case represents an individual with accelerating hypertension and declining kidney function associated with atherosclerotic renal artery stenosis. Key features include loss of GFR (reaching stage V CKD) during intensified antihypertensive drug therapy including agents that block the renin-angiotensin system and failure to appreciate the extent to which moderate renal artery stenosis was affecting his better kidney. Interpretation of duplex ultrasound studies was complicated by a discrepancy between near-normal peak systolic velocities and markedly abnormal segmental arterial waveforms. It was essential to recognize that both kidneys were abnormal and focus on recovery of perfusion to the better of these kidneys. Successful revascularization of one kidney allowed major improvement in GFR and BP control.

AB - This case represents an individual with accelerating hypertension and declining kidney function associated with atherosclerotic renal artery stenosis. Key features include loss of GFR (reaching stage V CKD) during intensified antihypertensive drug therapy including agents that block the renin-angiotensin system and failure to appreciate the extent to which moderate renal artery stenosis was affecting his better kidney. Interpretation of duplex ultrasound studies was complicated by a discrepancy between near-normal peak systolic velocities and markedly abnormal segmental arterial waveforms. It was essential to recognize that both kidneys were abnormal and focus on recovery of perfusion to the better of these kidneys. Successful revascularization of one kidney allowed major improvement in GFR and BP control.

UR - http://www.scopus.com/inward/record.url?scp=84923814041&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84923814041&partnerID=8YFLogxK

U2 - 10.2215/CJN.09030813

DO - 10.2215/CJN.09030813

M3 - Article

C2 - 24408123

AN - SCOPUS:84923814041

VL - 9

SP - 1117

EP - 1123

JO - Clinical Journal of the American Society of Nephrology

JF - Clinical Journal of the American Society of Nephrology

SN - 1555-9041

IS - 6

ER -