메뉴 건너뛰기
.. 내서재 .. 알림
소속 기관/학교 인증
인증하면 논문, 학술자료 등을  무료로 열람할 수 있어요.
한국대학교, 누리자동차, 시립도서관 등 나의 기관을 확인해보세요
(국내 대학 90% 이상 구독 중)
로그인 회원가입 고객센터 ENG
주제분류
인문학
인문학 일반 역사학 철학 종교학 어문학 기타 인문학
사회과학
사회과학 일반 경영학 관광학 교육학 군사학 문헌정보학 법학 사회학 신문방송학 심리과학 정치외교학 지리학 행정학 경제학 무역학 인류학 기타 사회과학
자연과학
자연과학 일반 물리학 생물학 생활과학 수학·통계학 천문학 지구과학 화학 기타 자연과학
공학
공학 일반 건축공학 기계공학 산업공학 재료·에너지공학 전기전자공학 조선해양공학 화학공학 컴퓨터학 기타공학
의약학
의학 일반 간호학 수의학 약학 한의학 기초의학 임상의학 기타 의약학
농수해양학
농수해양학 일반 농학 수산학 식품과학 임학 축산학 해상운송학 기타 농수해양학
예술체육학
예술 일반 디자인 미술 미용 사진 음악학 의상 체육 공연매체예술 기타 예술체육학
복합학
학제간연구 과학기술학 뇌인지과학 기술정책 기타 복합학

ENG

추천
검색

논문 기본 정보

자료유형
학술저널
저자정보
저널정보
대한고혈압학회 Clinical Hypertension Clinical Hypertension 제26권 제3호
발행연도
2020.1
수록면
8 - 12 (5page)

이용수

표지
📌
연구주제
📖
연구배경
🔬
연구방법
🏆
연구결과
AI에게 요청하기
추천
검색

초록· 키워드

오류제보하기
Background Renal artery stenosis is a notorious cause of secondary hypertension which classically presents as chronic refractory hypertension, recurrent flash pulmonary edema or renal insufficiency after initiation of an angiotensin converting enzyme inhibitor. Rarely, there have been reported cases of pregnant patients presenting with new onset or superimposed preeclampsia secondary to renovascular hypertension. In this subset of patients, renovascular hypertension carries significantly higher risks including obstetric, fetal and medical emergencies and death. Prompt treatment is required. However, the teratogenic risks of radiological investigations and antihypertensive medications limit diagnostic and management options thus posing quite a dilemma. Case presentation A 38-year-old female, at 33 weeks of gestation, was hospitalized for preeclampsia with severe features. A viable neonate had been expeditiously delivered yet the patient’s post-partum blood pressures remained severely elevated despite multi-class anti-hypertensive therapy. Renal artery dopplers revealed greater than 60% stenosis of the proximal left renal artery and at least 60% stenosis of the right renal artery. Renal angiography showed 50% stenosis of the left proximal renal artery for which balloon angioplasty and stenting was performed. The right renal artery demonstrated less than 50% stenosis with an insignificant hemodynamic gradient, thus was not stented. Following revascularization, the patient’s blood pressure improved within 48 h, on dual oral antihypertensive therapy. Conclusions Preeclampsia that is refractory to multi-drug antihypertensive therapy should raise suspicion for renal artery stenosis. Suspected patients can be screened safely with Doppler ultrasonography which can be then followed by angiography. Even if renal artery stenosis does not seem severe, early renal revascularization may be considered in patients with severe preeclampsia who do not respond to antihypertensive management. Background Renal artery stenosis is a notorious cause of secondary hypertension resulting from the activation of the renin-angiotensin system in response to reduced renal blood flow. Classic presentations include chronic refractory hypertension, recurrent flash pulmonary edema and renal insufficiency after initiation of an angiotensin converting enzyme inhibitor. Although rare, there have also been reported cases of pregnant patients presenting with new onset or superimposed preeclampsia secondary to renovascular hypertension [1, 2]. In this subset of patients, renovascuar hypertension carries significantly higher risks including obstetric, fetal and medical emergencies and death. Prompt treatment is required. However, the teratogenic risks of radiological investigations and antihypertensive medications such as angiotensin converting enzyme inhibitors or aldosterone antagonists limit management options and poses quite the dilemma. When possible, expedited delivery is beneficial; notwithstanding the fact that there has been success with interventional treatment prior to successful delivery. Furthermore, even after delivery, the mortality risk of pre-eclampsia continues into the post-partum period thus urgent and aggressive treatment strategies should continue to be pursued for these patients including consideration of early revascularization.

목차

등록된 정보가 없습니다.

참고문헌 (12)

참고문헌 신청
Heyborne KD / 1991 / Renal artery stenosis during pregnancy : a review / Obstet Gynecol Surv 46(8):509~514 google schola Margueritte F / 2016 / Successful angioplasty during pregnancy for renal artery stenosis / J Obstet Gynaecol Res 42:341~345 google schola Williams GJ / 2007 / Comparative accuracy of renal duplex sonographic parameters in the diagnosis of renal artery stenosis : paired and unpaired analysis / AJR Am J Roentgenol 188:798~811 google schola Drieghe B / 2008 / Assessment of renal artery stenosis : side-byside comparison of angiography and duplex ultrasound with pressure gradient measurements / Eur Heart J 29:517~524 google schola Vasbinder GB / 2004 / Accuracy of computed tomographic angiography and magnetic resonance angiography for diagnosing renal artery stenosis / Ann Intern Med 141:674~682 google schola

함께 읽어보면 좋을 논문

논문 유사도에 따라 DBpia 가 추천하는 논문입니다. 함께 보면 좋을 연관 논문을 확인해보세요!

이 논문의 저자 정보

최근 본 자료

전체보기

댓글(0)

0