CEN case reports · 2022
A case of malignant nephrosclerosis occurring with serum renin in the normal range.
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Sawamura Masato, Sawa Naoki, Oshima Yoichi, Ikuma Daisuke, Yamanouchi Masayuki, Hayami Noriko, Sekine Akinari, Mizuno Hiroki, Hasegawa Eiko, Suwabe Tatsuya, Hoshino Junichi, Kono Kei, Kinowaki Keiichi, Ohashi Kenichi, Ubara Yoshifumi
Аннотация
A 37-year-old Japanese man was admitted to our hospital for evaluation of severe hypertension and visual impairment. His serum creatinine was 4.16 mg/dL. Plasma renin activity was normal (2.7 ng/mL/h), but plasma aldosterone concentration was elevated (27.2 ng/dL). A kidney biopsy showed concentric subendothelial edematous thickening of the arterioles (onion skin pattern) with luminal narrowing or obstruction, and malignant nephrosclerosis was diagnosed. Antihypertensive therapies, including an angiotensin II receptor blocker and spironolactone, were administered and effectively preserved kidney function and normalized blood pressure. This case indicates that hyperaldosteronemia in the presence of normal renin levels might also cause malignant hypertension.