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Hypertension Post – Renal Trauma

Created: 14/2/2007
Updated: 16/4/2007

 

Hypertension Post – Renal Trauma

  • Hypertension is rarely noted in the early postinjury period
  • Data for hypertension in the long-term is lacking presumably because patients do not attend for follow-up

Pathophysiology

The development of hypertension is related to

  • 1 Renal artery injury or thrombosis
  • 2 Compression of the renal parenchyma by haematoma or fibrosis
  • 3 Post traumatic arteriovenous fistulae

NB -These can lead to renal ischaemia, excess renin production and ultimately hypertension

  • The exact incidence of hypertension post renal trauma is unknown
  • Older studies rates report incidence up to 5%
  • However, more recent studies occurs in less than 1% and certainly the risk of hypertension alone does not warrant surgical exploration in cases with non-perfused renal segments
  • Surgical treatment of hypertension maybe indicated in those patients who do not respond to medical therapy
  • As follow-up most clinicians would advise an regular blood pressure checks within the 1st year and annually thereafter

References

Varying course of hypertension following renal trauma.
von Knorring J, Fyhrquist F, Ahonen J.
J Urol. 1981 Dec;126(6):798-801.

Hypertension following renal trauma.
Watts RA, Hoffbrand BI.
J Hum Hypertens. 1987 Sep;1(2):65-71.

Efficacy of nephrectomy for the treatment of nephrogenic hypertension in a pediatric population.
Baez-Trinidad LG, Lendvay TS, Broecker BH, Smith EA, Warshaw BL, Hymes L, Kirsch AJ.
J Urol. 2003 Oct;170(4 Pt 2):1655-7; discussion 1658

Blunt renal trauma-induced hypertension: prevalence, presentation, and outcome.
Chedid A, Le Coz S, Rossignol P, Bobrie G, Herpin D, Plouin PF.
Am J Hypertens. 2006 May;19(5):500-4.


ArticleDate:20070214
SiteSection: Article
 
   
    
                                            



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