arthyperАртериальная гипертензия"Arterial’naya Gipertenziya" ("Arterial Hypertension")1607-419X2411-8524Antihypertensive League10.18705/1607-419X-2026-2606QRENHUarthyper-2606Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИORIGINAL ARTICLESЭффективное лечение резистентной артериальной гипертензии у больной с критическим стенозом почечной артерии единственной почки (описание клинического случая и обзор литературы)Effective management of resistant hypertension in a patient with critical renal artery stenosis of a solitary kidney (case report and literature review)https://orcid.org/0000-0002-8788-0076БарановаЕ. И.BaranovaE. I.

Баранова Елена Ивановна — доктор медицинских наук, профессор кафедры терапии факультетской с курсом эндокринологии, кардиологии с клиникой им. акад. Г. Ф. Ланга, директор НИИ сердечно-сосудистых заболеваний НКИЦ

Санкт- Петербург

Elena I. Baranova, MD, PhD, DSc, Professor, Department of Therap

St Petersburg

baranova.grant2015@yandex.ruhttps://orcid.org/0000-0002-4544-2967КуликовА. Н.KulikovA. N.

Куликов Александр Николаевич — доктор медицинских наук, профессор, заведующий кафедрой пропедевтики внутренних болезней с клиникой имени акад. М. Д. Тушинского

Санкт-Петербург

Aleksandr N. Kulikov, MD, PhD, DSc, Professor, Head, Propaedeutic Department

St Petersburg

ankulikov2005@yandex.ruhttps://orcid.org/0000-0003-2698-7977КацапА. А.KatsapA. A.

Кацап Анна Александровна — кандидат медицинских наук, доцент кафедры терапии факультетской с курсом эндокринологии, кардиологии с клиникой им. акад. Г. Ф. Ланга

Санкт-Петербург

Anna A. Katsap, MD, PhD, Assistant Professor, Department of Therapy

St Petersburg

annakatsap@inbox.ruhttps://orcid.org/0000-0002-1264-1425МетлинскаяА. И.MetlinskaiaA. I.

Метлинская Анна Ивановна — врач-кардиолог 1-го кардиологического отделения

Санкт-Петербург

Anna I. Metlinskaia, MD, Cardiologist, the First Cardiology Department

St Petersburg

shaban_anea@mail.ruФедеральное государственное бюджетное образовательное учреждение высшего образования «Первый Санкт-Петербургский государственный медицинский университет имени академика И. П. Павлова» Минздрава РоссииРоссияPavlov UniversityRussian Federation202615072026322160172Copyright © Баранова Е.И., Куликов А.Н., Кацап А.А., Метлинская А.И., 20262026Баранова Е.И., Куликов А.Н., Кацап А.А., Метлинская А.И.Baranova E.I., Kulikov A.N., Katsap A.A., Metlinskaia A.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://htn.almazovcentre.ru/jour/article/view/2606

Реноваскулярная артериальная гипертензия (АГ) атеросклеротического генеза — одна из частых причин резистентной АГ в пожилом и старческом возрасте. Вместе с тем нередко эта причина АГ остается не диагностированной, а, следовательно, и не устраненной. Описан клинический случай резистентной АГ у женщины старческого возраста с единственной почкой (нефрэктомия в анамнезе), осложненной развитием хронической болезни почек (ХБП), острым повреждением почки, рецидивирующими эпизодами острой сердечной недостаточности, острым инфарктом миокарда. Установлена причина резистентной АГ — атеросклеротическая субокклюзия почечной артерии, проведены ангиопластика и стентирование. Интервенционное лечение было оправдано, несмотря на критическое состояние пациентки. Успешная реваскуляризация привела к достижению целевого уровня артериального давления (АД), прекращению эпизодов острой сердечной недостаточности, успешному лечению острого повреждения единственной почки. Стабильное состояние пациентки сохраняется более двух лет. В статье содержатся современные представления о диагностике реноваскулярной АГ и тактике ведения больных с данной патологией, особое внимание уделяется показаниям для реваскуляризации почек.

Atherosclerotic renovascular hypertension is one of the most common causes of resistant hypertension in elderly age. However, this cause of hypertension often remains undiagnosed and untreated. The article describes a clinical case of resistant arterial hypertension in an elderly patient with a single kidney (history of nephrectomy), complicated by chronic kidney disease, acute kidney injury, recurrent episodes of acute heart failure and myocardial infarction. The cause of resistant arterial hypertension was established — critical atherosclerotic stenosis of the renal artery of solitary kidney. Angioplasty and stenting were performed in the critical condition of the patient, but it was justified. Successful revascularization resulted in control of hypertension, cessation of episodes of acute heart failure and acute kidney injury. The stable clinical condition persists for more than two years. This article contains modern concepts of diagnosis and management of renovascular hypertension, special attention is paid to indications of renal revascularization.

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The authors declare that there are no conflicts of interest present.