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Local release of renin unveils intrarenal arterial fibromuscular dysplasia

Title: Local release of renin unveils intrarenal arterial fibromuscular dysplasia
Authors: Fava, Cristiano; Dal Pont, Chiara; Sartorio, Andrea; Contro, Alberto; Mansueto, Giancarlo; Minuz, Pietro
Contributors: Fava, Cristiano; Dal Pont, Chiara; Sartorio, Andrea; Contro, Alberto; Mansueto, Giancarlo; Minuz, Pietro
Publication Year: 2025
Collection: Università degli Studi di Verona: Catalogo dei Prodotti della Ricerca (IRIS)
Subject Terms: arterial fibromuscular dysplasia; arterial hypertension; branch renal artery stenosis; cervical arteries; multisite; renal artery angioplasty; renovascular disease; unifocal
Description: A previously healthy young man developed severe hypertension requiring triple antihypertensive therapy. Initial evaluation identified hyperreninemic hyperaldosteronism, mild hypokalaemia, hypodensity within the right kidney at computed tomography (CT), normal renal arteries at echography. He was referred to Verona ESH Centre were angio-CT revealed significant stenosis of an aberrant branch artery of the right kidney with hypo-perfused area colocalizing with a hypo-oxygenated area, as assessed by BOLD-MR imaging. Super-selective sampling found high plasma renin concentrations only in the vein draining the lower pole of the right kidney. Renal angiography confirmed tightened stenosis of an aberrant branch artery supplying the lower arterial segments, consistent with unifocal medial fibromuscular dysplasia, successfully treated with angioplasty. Investigating extra-renal sites, angio-MR found an S-shaped loop of extracranial left internal carotid artery, consistent with multisite fibromuscular dysplasia. This clinical case underscores the importance of comprehensive functional and imaging tests to identify elusive causes of secondary hypertension.
Document Type: article in journal/newspaper
Language: English
Relation: info:eu-repo/semantics/altIdentifier/pmid/40084463; info:eu-repo/semantics/altIdentifier/wos/WOS:001457711100003; volume:43; issue:5; firstpage:909; lastpage:913; numberofpages:5; journal:JOURNAL OF HYPERTENSION; https://hdl.handle.net/11562/1157630
DOI: 10.1097/HJH.0000000000003987
Availability: https://hdl.handle.net/11562/1157630; https://doi.org/10.1097/HJH.0000000000003987
Rights: info:eu-repo/semantics/openAccess ; license:Creative commons ; license uri:http://creativecommons.org/licenses/by-nc-nd/4.0/
Accession Number: edsbas.85FC199D
Database: BASE