7 Year Follow up of Renal Artery Stenosis due to Fibromuscular Dysplasia

Abstract

Case Presentation

A 23 years old absolutely alright one month back when he developed high grade fever, consulted some General practitioner at Multan and was found hyper-tensive during his routine check-up. His routine lab investigation showed persistent hypokalemia. He was referred to cardiology OPD with uncontrolled hyper-tension. He was given ACE inhibitor and beta blocker were given but the hypertension remain uncontrolled. His serum urea 20 mg/dl (15 - 45 mg/dl) Serum creati-nine 0.8 mg/dl (0.4 - 1.4 mg/dl).

Urine examination:  Unremarkable.

Abdominal Ultrasound:  Right kidney slightly small-ler. Compensatory hypertrophy of left kidney.

Renal Scan:  Slightly reduced functioning left kidney. Reduced functioning small sized, right kidney.

Echocardiography:  Normal, with normal ejection fraction.

Angiography was planned which shows right sided renal artery stenosis. Angioplasty was done on 11/07/2001 with TIMI grade III adequate post stenting blood flow. After the angioplasty patient remain nor-motensive without antihypertensive medication.

Follow up angiography was done on 26/3/2003 whi-ch shows normal functioning patent right renal artery stent. Complete blood count urea creatinine, within normal limit. 2007 patient Color Doppler of renal artery was done which shows normal patent renal arte-ries and no antihypertensive medication was given to this patient in these 8 years. So angioplasty with stent-ing is the treatment of choice for renal artery stenosis due to fibromuscular dysplasia.