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.
- Blunt renal trauma (RT) may cause hypertension.
- We assessed the frequency and mechanisms of RT, and blood pressure (BP) outcome after treatment
- We searched the records of all patients referred to our hypertension unit and included those of previously normotensive patients who developed hypertension within 6 months of RT.
- Ten of the 17,410 referred patients, with a median age of 26 years, developed hypertension 0 to 3 months after a well-documented RT.
- Median BP at referral was 170/107 mm Hg. Median glomerular filtration rate was 89 mL/min.
- Five patients had hematuria. Median kidney length was 107 mm on the damaged side and 114 mm on the opposite side.
- Renal artery lesions were present in six cases. A pattern of unilateral renin hypersecretion and contralateral suppression was present in five of eight cases with unilateral RT.
- Six patients underwent surgery.
- Seven months after referral, median BP was 128/79 mm Hg. The BP was <140/90 mm Hg without medication in one patient who did not undergo surgery and in three patients who did.
- Renal trauma is a rare cause of hypertension, mostly in young men. Hypertension is usually renin dependent and associated with parenchymal injury. The RT-induced hypertension may resolve spontaneously and is amenable to surgery.