Nephro-HTN Flashcards
What testing should be performed for newly diagnosed hypertension?
*kidney function, fasting plasma serum glucose, fasting serum lipid panel, serum potassium, serum calcium
- EKG to assess for LVH or silent MI
- UA to look for albuminuria
*Echo not needed
When is an echo used as part of initial hypertension workup?
**HVC
Use it for patients with known heart disease
Presence of a LBBB on electrocardiogram
suspected white coat hypertension
If someone’s blood pressure is uncontrolled on a moderate dose of one BP med, what do you do?
You add a second at a moderate dose. This avoids the side effects of increasing to a high dose.
What are the clinical manifestations of renovascular hypertension? How diagnosed? Management?
Recurrent episodes of “flash” pulmonary edema or marked elevation in serum creatinine with control of BP, especially with use of an ACEI or ARB
Dx: Duplex doppler is effective screening test, however, MR or CT angiography is better and the GOLD STANDARD is renal arteriography
Tx: **No data showing that stenting or angioplasty is better than medical management… so what you do is give meds and modify CV risk factors
In renovascular hypertension, when do you actually use a stent?
flash pulmonary edema with bilateral renal artery stenosis, and in young women with fibromuscular dysplasia
What do you think of when you have hypokalemia and hypertension?
Hyperaldosteronism from an aldosterone producing adenoma or bilateral idiopathic hyperaldosteronism
