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All Journal International Journal of Integrated Health Sciences Majalah Kedokteran Bandung Althea Medical Journal Jurnal Sistem Kesehatan Indonesian Journal of Rheumatology Pharmacology and Clinical Pharmacy Research Indonesian Journal of Kidney and Hypertension Indonesian Journal of Global Health research The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy Jurnal MedScientiae Jurnal MedScientiae
Rudi Supriyadi
Division Of Nephrology And Hypertension, Department Of Internal Medicine, Faculty Of Medicine, Universitas Padjadjaran/Hasan Sadikin General Hospital, Bandung
Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Medicine & Pharmacology Neuroscience Nursing Public Health

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Ruptured Renal Artery Aneurysm in a Young Man with Uncontrolled Hypertension Sekarini, Ajeng Ayu; Sukesi, Lilik; Supriyadi, Rudi
Indonesian Journal of Kidney and Hypertension Vol 3 No 1 (2026): Vol 3 No 1 (2026): Volume 3 No. 1, April 2026
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32867/inakidney.v3i1.230

Abstract

Renal artery aneurysm (RAA) is a rare renovascular condition that may represent both a consequence of long-standing hypertension and an underrecognized cause of secondary hypertension, particularly in young patients. A 23-year-old man with a four-year history of poorly controlled hypertension (peak blood pressure 170/100 mmHg) presented with acute left flank pain. On admission, blood pressure was 154/110 mmHg with severe anemia (hemoglobin 6.3 g/dL), preserved renal function (creatinine 1.18 mg/dL), and mild proteinuria (1+) without hematuria. Contrast-enhanced CT angiography demonstrated a 2.54-cm saccular RAA (Rundback type I) arising from the left renal artery, accompanied by a large perirenal hematoma measuring 8.3 × 6.7 × 14.2 cm, consistent with rupture. The patient had been taking intermittent captopril 12.5 mg once daily prior to admission. Selective endovascular coil embolization using a 3.3-mm VortX coil via right femoral access was successfully performed, achieving complete aneurysm exclusion with preserved renal perfusion. This case highlights the bidirectional relationship between hypertension and RAA. Chronic hypertension likely contributed to aneurysm formation, while intrarenal hemodynamic disturbances may have activated the renin-angiotensin-aldosterone system (RAAS), leading to secondary hypertension. The marked improvement in blood pressure following intervention supports a reversible renovascular mechanism. RAA should be considered in young patients with uncontrolled or resistant hypertension. Early vascular imaging and timely endovascular management are essential to prevent life-threatening complications and address reversible renovascular hypertension.
Co-Authors . SETIAWAN Ajeng Diantini, Ajeng Anthoni Anthoni Arto Y. Soeroto Bayu Laksono Budhi Prihartanto Christine Elizabeth Suryajaya David Kristianus David Paranoan Davin Takaryanto Davin Takaryanto Gaga Irawan Nugraha Herri S. Sastramihardja Hikmat Permana Hikmat Permana Ibrahim, Susannia Ivena Ivena Kartika Malahayati Kusumawati, Maya Laniyati Hamijoyo Laurensia Imelda Lazuardhi Dwipa Liza Karina Hauteas Lukman Pura Malahayati, Kartika Maria Riastuti Iryaningrum Muhammad Begawan Bestari Muhammad Iqbal Nanny N. M. Soetedjo Nanny N. M. Soetedjo Nanny Natalia Mulyani Soetedjo Nenny Agustanti Nenny Agustanti Nida Dwi Nafisah Nida Suraya Nida Suraya Noormarina Indraswari Nuraini Yasmin Kusumawardhani Rachmat Soelaeman Ria Bandiara Ritonga, Ervita Rizka Putri Hamuktiono Rizka Putri Hamuktiono, Rizka Putri Sekarini, Ajeng Ayu Siska Wiramihardja, Siska Siti Aminah Abdurachman Siti Nur Fatimah Sukesi, Lilik Susannia Ibrahim Susantina Prodjosoewojo Yenni Zuhairini Yenni Zuhairini Yulia Sofiatin