Habibullah Khan, Ihsanulah Mahsud, Hidayatullah Mahsud, Shaukat Ali.
Renal artery stenosis.
Gomal J Med Sci Jan ;3(2):67-8.

A Forty-eight years gentleman, presented with a history of hypertension for the last 17 years. During this protracted period he had been using various medications to combat hypertension. At presentation he was using Amlodipine 5mg and Metoprolol 50mg daily. On examination his BP was 160/100 mmHg. There was no radio-femoral delay or abdominal bruit. Cardiovascular examination was unremarkable. Laboratory investigations revealed normal renal function. A difference in the size of the two kidneys was noticed on ultrasonography. The size of the right kidney was 9.2 x 3.6 cm and that of the left 11.1 x 5.3 cm. Investigations at referral centre revealed serum creatinine 120 µmol /l, serum sodium 139 mmol/l, serum potassium 4.0 mmol /l and plasma rennin 4.29 mcg /ml (Reference range 0.31-3.95 mcg /ml). A renal angiogram was performed which revealed critical stenosis of the right renal artery. Percutaneous renal angioplasty and stenting was performed and it was successfully dilated. After the procedure although the patient still has hypertension but the response to medications is favourable demonstrating signs of stability. We are planning to gradually taper off his antihypertensive medications.

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