Clin Hypertens.  2018 ;24(1):15. 10.1186/s40885-018-0100-x.

Renin dependent hypertension caused by accessory renal arteries

• Chan PL
• Tan FH

• KMID: 2434269
• DOI: http://doi.org/10.1186/s40885-018-0100-x

Abstract

BACKGROUND
Hypokalemia in the presence of hypertension is often attributed to primary hyperaldosteronism as a cause of secondary hypertension, however secondary hyperaldosteronism may present similarly. Accessory renal arteries are variants in the vascular anatomy which are often thought to be innocuous but in some circumstances can cause renovascular hypertension leading to secondary hyperaldosteronism.
CASE PRESENTATION
We report 2 cases of hypertension with secondary hyperaldosteronism associated with accessory renal arteries. Both patients presented with hypokalemia and further investigations revealed hyperaldosteronism with unsuppressed renin levels. Imaging studies showed the presence of accessory renal artery.
CONCLUSION
Accessory renal arteries are a potential cause renovascular hypertension which can be detected via CT angiography or magnetic resonance angiography. Hormonal evaluation should be undertaken to determine whether its presence contributes to hypertension in the patient as targeted treatment such as aldosterone antagonist can be initiated. Surgical intervention or renal denervation may be considered in resistant cases.

Keyword

Accessory renal artery; Secondary hyperaldosteronism; Renovascular hypertension

MeSH Terms

Aldosterone
Angiography
Denervation
Humans
Hyperaldosteronism
Hypertension*
Hypertension, Renovascular
Hypokalemia
Magnetic Resonance Angiography
Renal Artery*
Renin*
Aldosterone
Renin