Hipertensi Renovaskular

Abstract

AbstrakHipertensi renovaskular adalah peningkatan tekanan darah sistolik dan atau diastolik yang umumnya mendadak dan resisten akibat hipoperfusi ginjal yang biasanya disebabkan stenosis arteri renalis dan aktivasi sistem renin-angiotensin. Penyakit ini merupakan salah satu penyebab dari hipertensi sekunder yang dapat terjadi karena gangguan pada vaskular berupa stenosis arteri renalis, berkaitan dengan penyakit parenkim ginjal atau dapat juga merupakan kombinasi dari keduanya. Angka kejadiannya yaitu 1-4 % dari seluruh penderita hipertensi. Hipertensi renovaskular lebih sering ditemukan pada usia remaja dibandingkan pada kelompok usia dewasa. Tujuan penatalaksanaan hipertensi renovaskular adalah memperbaiki oklusi arteri renalis sehingga hipoperfusi ginjal membaik dan tekanan darah menurun. Dalam kasus ini kami melaporkan seorang perempuan berusia 22 tahun datang dengan keluhan sakit kepala sejak 1 hari sebelum masuk rumah sakit. Hasil angiografi arteri renalis: stenosis 80-90% pada arteri renalis dextra. Selanjutnya pasien dilakukan Percutaneous Transluminal Renal Angioplasty. Setelah dilakukan pemasangan balon arteri renalis keluhan sakit kepala berkurang dan tekanan darah menjadi normal dan obat antihipertensi dihentikan. Kata kunci: hipertensi renovaskular, stenosis arteri renalis, Percutaneous Transluminal Renal Angioplasty AbstractRenovascular hypertension is an increment in systolic and / or diastolic blood pressure which is generally abrupt and resistant due to renal hypoperfusion which is usually caused by renal artery stenosis and activation of the renin-angiotensin system (RAS). Renovacular hypertension can occur due to vascular disorders, related to renal parenchymal disease or the combination of both. Renovascular hypertension is 1-4% of all hypertensive patients. Renovascular hypertension is more common in adolescents than in the adult age group. The aim of renovascular hypertension management is to remedy renal artery occlusion in order to kidney hypoperfusion improves and blood pressure decreases. Herein we report a case of 22 years old female presenting with a headache 1 day prior to hospital admission. Renal artery angiography results: 80-90% stenosis in dextra renal arteries. Furthermore, the patient is performed Percutaneous Transluminal Angiography. After the installation of renal artery balloon, the headache complaint of this patient decreases and blood pressure becomes normal and the antihypertensive drugs is stopped

Renal artery stenosis: the challenging in diagnosis and therapy

“…Narrowing of arterial lumen up to 75% is associated with a significant decline © Деві І. П., Деві К. П., Мардіана Н., 2020. УДК: 616.136.7:616.61]-07-085 Івана П. Деві 1,2 , Крістін П. Деві 1,2 , Н. Мардіана 1,3 Стеноз ниркової артерії: складне діагностичне та терапевтичне завдання of glomerular filtration rate (GFR). ARAS can worsen over time, causing hypertension and chronic kidney disease [2].…”

“…FMD is usually seen in women and young age (40-80%). FMD is more commonly found in the Caucasians compared to African Americans or in Asian populations [3].…”

“…• Abrupt onset of hypertension with fast progression from mild to severe, • The onset of HT<30 years without familial history of severe HT >55 years, • Hypertension w/ recurrent pulmonary edema, • Resistant hypertension with 3 or more antihypertension drugs in optimal dose, • Hypertension with worsening of renal function after ACEI or Angiotensin Receptor Blocker (ARB) therapy, • Hypertension with a history of occlusive vascular disease: CAD, stroke, peripheral occlusive vascular disease, abdominal aorta aneurysm [3]. Hypertension that cannot be controlled with drugs will disrupt the function of both kidneys due to a lack of blood supply (ischemic nephropathy).…”