腎血管性高血圧にネフローゼ症候群を合併した高齢者のインスリン非依存型糖尿病の1例

Abstract

A case of renovascular hypertension (RVH) with nephrotic syndrome (NS) is reported. The patient was a 68-year-old woman with a 10-year history of non-insulin- dependent diabetes mellitus. She was admitted to our hospital for investigation of massive proteinuria and severe hypertension (240/100mmHg). Laboratory findings were as fol- lows : urinary protein excretion was 12.4g/day, serum creatinine was 1.8mg/dl, plasma renin activity was 12.4ng/ml/hr, and plasma aldosterone concentration was 202pg/dl. Abdominal ultrasound showed a contracted right kidney (77 × 37mm vs. 102 × 53mm on the left), and stenosis of the right main renal artery (no blood flow was detected). RVH is seldom complicated by NS. The relationship between them is unclear, but NS may be based on compensatory glomerular hyperfiltration in the normal kidney caused by RVH.