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15歳,男子.高血圧,水腎症の精査目的で受診.諸検査より両側腎盂尿管移行部狭窄症および右腎による高レニン性高血圧と診断した.術前に経皮的に腎瘻を造設し,腎盂内圧を減圧することにより末梢血レニン活性が正常化することを確認した.右腎盂形成術を施行後,高レニン血症は是正され高血圧も軽快した.本症例は両側性水腎症であったが,高血圧の原因としては右腎のレニン分泌異常によるものと考えられた.
A case of hypertension secondary to hydronephrosis in a 15-year-old boy is reported. Clinical examina-tions confirmed the diagnosis of bilateral hydronephrosis due to congenital obstruction of ureteropelvic junction with renin-dependent hypertension. Plasma renin activity (PRA) was elevated in periferal veins and significantly in the right renal vein. Preoperatively, right hydronephrosis was decompressed by percutaneous nephrostomy and periferal PRA returned to normal. After pyeloplasy, blood pressure and periferal PRA returned to normal.
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