Fluid retention

Vasoconstriction
1-2
Angiotensinogen to angiotensin 1
Pituitary adenomas
Aldosterone
JGA baroreceptors
Cranial cushings
Masses
Alpha blocker
Midnight and 9am cortisol
ACTH
Adrenalectomy
High dose dexamethaxone test
Ectopic ACTH syndrome
Transsphenoidal resection
Low dose dexamethaxone suppression test
Tumours
Beta blocker
Renin secretion
Alpha methyl 1 tyrosine
CT/MRI
ACE
Ectopic CRH
Angiotensin 2
Truncal obesity
Von Recklinhausen
Nephrectomy
Parodysmal HPT
Kidneys
Gold standard
9amm/midnight
Surgery
NB for FMD
Spontaneous hypokalaemia
1% of HPT
Nephroblastoma
<30%
String of beads
24hr urinary metanephrines
70% or more
<30y
RAAS activation
Radioisotope scan
ACTH dependent
30-69%
Medical
Atherosclerotic RAS
Screening
24hr urinary cortisol
For Ostial lesions
Features
Us adrenals
Pain
Hypernatraemia/ M acidosis
Dorso cervical adiposity
Von Hippel Lindau
ACTH independent
Aorta renal bypass
Medical
Surgical
Conrmation
CT/MRI
Palpitations
Thrombo endarterectomy
Aldosterone and ACTH levels
Hisuitism
MEN
RA reimplantation
Moon face
Plasma catecholamines
Pallor
Perspiration
Extra anatomical bypass
Psychosis
Complex repairs
Gen
Severe HPT
Hypercortisolism
Cortisol screen
RAS
Features
Renal duplex US
Mild
FMD
Balloon angioplasty
Renin dependent HPT
ACE I
Ostial
Early onset HPT
Dx
Late onset HPT
Takaysu's
Moderate
Stenting
Ischaemic nephropathy
B blockers
Coarctation of the aorta (thoracic)
Renal parenchymal disorders
Types
Volume dependent HPT
Aldosterone
Parostial
Dx
CTA
RA dissection
Clinical features
Surgery
Truncal
Familial syndromes
Ca Channel blockers
Renin
MRA
Mid aortic syndrome
Medical rx
Severe
Severe HPT
Mixed
Conventional renal angiography
Urine metanephrines
Diuretics
Malignant HPT
Neurobromatosis
Rx
Dx
Catecholamines
Rx
Risk factor control
Multi drug therapy required
Segmental
Trauma
Medically refractory
TFTs
Lipid lowering
CT abdo/brain/chest
Accessory
Aneurysms
US thyroid
PTH/Ca/PO4
Epigastric bruits
Anti platelets
Grade 3/4 HPT retinopathy
MAG 3 renogram
Flash pulm oedema
Captopril renogram
Refractory angina
Goldblatt model
Clinical
Secondary HPT
Medical
Cushings
Native RAS
Imaging
Severe HPT due to decreased renal perfusion
RAS
2nd HPT
Atherosclerotic RAS 95%
5% of cases
Anastomotic RAS
Endocrine screen
Surgical
Due to
Atherosclerotic RAS
Coarctation of the aorta
Primary hyperaldosteronism
Phaechromocytoma
Any vascular pathology that
produces hypo perfusion of the
kidneys resulting in hypertension
Middle aortic syndrome
Non atherosclerotic
Renal artery occlusion
Hyperthyroidism
Hyperparathyroidism
Intro
D
e
n
itio
n
Endocrine
C
lassication
R
enovascular
P
athological classication
Pathophysiology
R
x
Presentation
Investigations
Renovascular
hypertension
Secondary HPT