Effective management of resistant hypertension in a patient with critical renal artery stenosis of a solitary kidney (case report and literature review)

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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