Could Renal Vascular Variations Be Associated with Resistant Hypertension? A Single-Center Study

Figures

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  Figure 1. Contrast-enhanced CT imaging of a 44-year-old female patient with high blood pressure refractory to treatment, revealed characteristic findings consistent with classic Nutcracker syndrome. In the presented image, the abdominal aorta, the superior mesenteric artery, and the left renal vein are indicated by yellow arrows. The compressed segment of the left renal vein is highlighted by a blue arrow. AA—abdominal aorta; CT—computed tomography; LRV—left renal vein; SMA—superior mesenteric artery.

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  Figure 2. Contrast-enhanced CT imaging of a 47-year-old female patient with refractory hypertension revealed an accessory renal artery in the left kidney, shown by the yellow arrow. ARA—accessory renal artery; CT—computed tomography.

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  Figure 3. Contrast-enhanced CT imaging of a 49-year-old female hypertensive patient failing to achieve blood pressure control by 4 drugs from different classes demonstrated an accessory renal artery in the right kidney, indicated by the yellow arrow. ARA—accessory renal artery; CT—computed tomography.

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  Figure 4. Contrast-enhanced CT imaging of a 43-year-old male patient with true resistant hypertension showed the presence of two renal arteries in the right kidney, indicated by the yellow arrows. CT—computed tomography; RA1—first renal artery; RA2—second renal artery.

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  Figure 5. Contrast-enhanced CT imaging of a 44-year-old male hypertensive patient with difficult-to-control HTN revealed two renal veins in the right kidney, marked by the yellow arrows. CT—computed tomography; HTN—arterial hypertension; RV1—first renal vein; RV2—second renal vein.

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  Figure 6. Dipping state of patients with renal vascular variations and normal renal vasculature. Normal dipping—physiological 10–20% lowering of SBP and DBP in the nighttime compared to the daytime values; non-dipping—fall of the nighttime SBP and/or DBP by only 1–9% to the daytime values; reverse dipping—elevation of the nighttime SBP and/or DBP to the daytime values; DBP—diastolic blood pressure; SBP—systolic blood pressure; p—p-value for statistical significance.