著者

Kota Nishihama Chisa Inoue Kohei Nishikawa Yuko Okano Atsuro Takeshita Mei Uemura Taro Yasuma Toshinari Suzuki Ryuji Okamoto Corina N D'Alessandro-Gabazza Esteban C. Gabazza Yutaka Yano

出版者

The Japanese Society of Internal Medicine

雑誌

Internal Medicine (ISSN:09182918)

巻号頁・発行日

pp.2613-23, (Released:2023-10-27)

参考文献数

27

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A 42-year-old Japanese woman with end-stage renal failure due to hypertension presented with a systolic blood pressure of 160-200 mmHg despite treatment with 4 different antihypertensive agents. The plasma aldosterone concentration (PAC) and plasma renin activity (PRA) were elevated. Adrenal vein sampling suggested bilateral excessive aldosterone secretion, whereas adrenocortical scintigraphy showed right-dominant accumulation. Open bilateral nephrectomy and right adrenalectomy improved the systolic blood pressure, PAC, and PRA. A pathological examination revealed zona glomerulosa hyperplasia but not microaldosteronoma. This report shows that bilateral nephrectomy, not unilateral adrenalectomy, is a potentially effective treatment option for resistant hypertension with an elevated renin-angiotensin-aldosterone system in hemodialysis patients.

著者

岡野 祐子 Yuko Okano

雑誌

時計台 (ISSN:09183639)

巻号頁・発行日

no.74, pp.20-21, 2004-04-01