ARTERIAL HYPERTENSION AND KIDNEY DISEASE – AN UNEXPECTED COMPLICATION

Abstract

Arterial hypertension and chronic kidney disease are causally linked. Unregulated arterial hypertension along with diabetes is one of the two most common causes of end-stage chronic kidney disease. On the other hand, chronic kidney disease, same as renal artery stenosis, results in the development of arterial hypertension.

Hypertensive crisis with target-organ damage, also known as a hypertensive emergency, is a serious arterial hypertension complication which, fortunately, is becoming less frequent. It requires urgent parenteral antihypertensive treatment adjusted to the values of arterial hypertension and accompanying clinical signs. Damage can manifest on numerous organ systems: eyes, brain, cardiovascular system, and kidneys.

This is a case study of a patient admitted with hypertensive crisis and kidney damage where treatment differentiated a dissection of the abdominal aorta expanding into the renal arteries, but without the typical clinical picture with stabbing pain. By performing a MSCT aortography, despite the risk, a definitive diagnosis was made, and the aetiology of the kidney damage and cause of the worsening arterial hypertension were ascertained.