Improvement of Renovascular Malignant Hypertension after Angioplasty

Malignant hypertension in young female with disparity in kidney size raise the attention toward non-essential renovascular hypertension. In this case we describe a young female suffered severe hypertension associated with deterioration of kidney function and disparity in kidney size by ultrasound. Hemodialysis was started because of electrolytes imbalance and fluid overload which is unusual with unilateral renal artery stenosis. Management by traditional antihypertensive medication was with limited benefit and patient condition required intensive care monitoring. Balloon dilatation angioplasty with stent insertion in the left renal artery was performed, blood pressure started to respond to anti-hypertensive medications but she became anuric. Daily hemodialysis session was done, after few days her condition started to improve and serum creatinine returned to normal base 1.1 mg/dl without dialysis support. The patient presentation was not classic toward either unilateral renal artery stenosis or reno-parenchymal disease.