A case of hyperreninemic hypertension after extracorporeal shock-wave lithotripsy

A 53-year-old mate was found to have hypertension caused by the significant secretion of renin from an atrophic left kidney. He had undergone extracor poreal shockwave lithotripsy (ESWL) for left renal lithiasis 11 years previ ously. A renal dynamic study with Tc-99m-diethylenetriaminepentaacetic acid (DTPA) indicated that the rate of renal excretion and uptake was decreased in the left kidney and normal in the right kidney. Renal angiography demon strated a normal right renal artery and a small but;nonstenotic left renal artery. The ratio of PRA in the left renal Vein to that In the right renal Vein was 1.7. Blood pressure could be lowered to the range of 140-150/80-90 mmHg with Imidapril, an ACE inhibitor. ESWL may cause hypertension via the well-known Page kidney effect. In this case, the kidney, atrophic probably due to ESWL, released a significant amount of renin.