Fibromuscular dysplasia causing renal artery aneurysm and renovascular hypertension: a case report.

OBJECTIVE: Renal artery aneurysm is a rare disease and usually is due to fibromuscular dysplasia. We describe a case in a woman who had renovascular hypertension due to aneurysm of fibromuscular dysplasia-associated renal artery. MATERIAL AND METHODS: The clinical presentation, renal function, radiologic data, complications and treatment were studied. RESULTS: To report a case of 37-year-old female with a history of hypertension in the last year in pharmacological therapy and in absence of other clinical symptoms. A Doppler ultrasound and a spiral tomography revealed the presence of a right renal artery aneurysm with a hypoplastic kidney. Controlateral kidney was normal. We carried out total nephrectomy to resolve high blood pression and the risk of rupture. The patient was discharged home in 5th post operative day. Serum creatinine level remained normal as it was before. Her blood pressure normalized over a period of several months using a single antihypertensive medication. CONCLUSION: We suggested that in presence of renovascular hypertension in young adult fibromuscular dysplasia-related renal artery aneurysm will be suspected. When possible aneurysmectomy and angioplastic renal artery closure or segmental renal artery reimplantation and renal artery bypass are the gold standard while nephrectomy will be reserved for unreconstructable renal arteries or advanced parenchymal disease.