A case with renovascular hypertension accompanied by focal segmental glomerulosclerosis like lesion in the contralateral kidney

Toshiki Shimada, Masaaki Nakayama, Hiroyuki Matsuda, Tatsuya Kanai, Yasuo Kimura, Atsushi Saitou, Izuru Inomata, Hiroaki Yoshida, Kazunori Takazoe, Takeyuki Kitajima, Osamu Sakai

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6 Citations (Scopus)

Abstract

A 19-year-old female patient with renovascular hypertension accompanied by focal segmental glomerulosclerosis like lesion in the contralateral kidney is described. She was admitted to our hospital for uncontrollable hypertension which was first pointed out at check-up when she was 18 years old. On admission physical examination revealed remarkable hypertension and a bruit around the umbilical region. Laboratory findings disclosed renal dysfunction and slight proteinuria (0.8-1.1 g/day). Arteriography revealed severe narrowing of the right renal artery suggesting fibromuscular dysplasia. Taken together, renovascular hypertension was diagnosed. She underwent an operation to reconstruct the artery with autotransplantation of the ipsilateral kidney in the pelvic cavity, and sections were taken from both kidney for histological evaluation during the procedure. After the operation her blood pressure normalized and proteinuria decreased. And interestingly, the kidney specimens revealed that the left side consisted of focal segmental glomerulosclerosis like lesion whereas the right was only of ischemic change. Hyperfiltration theory has recently been highlighted experimentally. And the etiology of the renal findings in this case may be based on such hemodynamic alteration as has been described in animal models. We present the case so that it may be of some help to understand how focal segmental glomerulosclerosis is brought about in humans.

Original languageEnglish
Pages (from-to)167-172
Number of pages6
JournalThe Japanese Journal Of Nephrology
Volume33
Issue number2
DOIs
Publication statusPublished - 1991 Jan

Keywords

  • focal segmental glomerulosclerosis
  • hyperfiltration
  • renovascular hypertension

ASJC Scopus subject areas

  • Nephrology

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    Shimada, T., Nakayama, M., Matsuda, H., Kanai, T., Kimura, Y., Saitou, A., Inomata, I., Yoshida, H., Takazoe, K., Kitajima, T., & Sakai, O. (1991). A case with renovascular hypertension accompanied by focal segmental glomerulosclerosis like lesion in the contralateral kidney. The Japanese Journal Of Nephrology, 33(2), 167-172. https://doi.org/10.14842/jpnjnephrol1959.33.167