Kelly J F, Atkinson A B, Adgey A A
Royal Victoria Hospital, Belfast, Northern Ireland.
Int J Cardiol. 1987 Sep;16(3):318-20. doi: 10.1016/0167-5273(87)90158-6.
This case report records the rare presentation of accelerated hypertension secondary to long-standing renal tuberculosis and the subsequent beneficial response to surgery predicted by lateralisation of renin levels within the renal veins. The patient's hypertension proved difficult to control medically and he was therefore assessed for possible surgical management. Renin sampling revealed clear lateralisation within the renal veins indicating possible benefits from surgery. Nephro-ureterectomy was performed and, post-operatively, the patient's hypertension, while not completely resolved, was easily controlled with monotherapy. Patients with unilateral renal tuberculosis and hypertension which prove difficult to control should have measurement bilaterally of renal venous renin which may indicate potential benefits from surgery.
本病例报告记录了由长期肾结核继发的加速性高血压的罕见表现，以及肾静脉肾素水平的侧化所预测的对手术的后续有益反应。事实证明，该患者的高血压在药物治疗上难以控制，因此对其进行了可能的手术治疗评估。肾素采样显示肾静脉内有明显的侧化，表明手术可能有益。患者接受了肾输尿管切除术，术后其高血压虽未完全缓解，但通过单一疗法即可轻松控制。单侧肾结核且高血压难以控制的患者，应双侧测量肾静脉肾素，这可能表明手术具有潜在益处。
