Key result
Partial nephrectomy for renal reninoma cures severe hypertension and normalizes plasma renin levels.
Why the study?
Reninoma is a rare, potentially curable cause of severe secondary hyperaldosteronism that requires optimal imaging, biochemical workup, and management strategies.
Case Report (n=1)
Reninoma is a rare, potentially curable cause of secondary hyperaldosteronism presenting with severe hypertension and hypokalemia, optimally managed by surgical resection.
Supports curative partial nephrectomy in reninoma; leaves open need for prospective data on outcomes.
A reninoma is a functional tumor of afferent arteriolar juxtaglomerular cells that secretes the enzyme renin, leading to hyperactivation of the renin-angiotensin-aldosterone system. Reninoma is a potentially curable cause of pathological secondary hyperaldosteronism that results in often severe hypertension and hypokalemia. The lack of suppression of plasma renin contrasts sharply with the much more common primary aldosteronism, but diagnosis is often prompted by screening for that condition. The major differential diagnosis of reninoma is renovascular hypertension. Fewer than 200 cases of reninoma have been described. Reninomas have been reported across a broad demographic but have a 2:1 predilection for women, often of childbearing age. Aldosterone receptor blockade, angiotensin-converting enzyme inhibitors, or angiotensin receptor blockers offer effective medical management but are contraindicated in pregnancy, so surgical curative resection is ideal. The current optimal imaging and biochemical workup of reninoma and management approach (ideally, tumor excision with subtotal renal resection) are described.
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Hayes et al. (2023) conducted a case report in Reninoma (n=1). Surgical resection (partial nephrectomy) vs. Medical management was evaluated on Resolution of hypertension and normalization of plasma renin levels. Surgical resection of a right renal reninoma via partial nephrectomy cured the patient's severe hypertension and normalized plasma renin levels, allowing complete cessation of antihypertensives.
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