Pelvic-ureteric junction obstruction and hypertension with target organ damage: A case report and review of the literature

Pelvic-ureteric junction obstruction (PUJO) is rare in adults and may be seen when the diagnosis has been missed in childhood. Hypertension may be a feature of PUJO but limited data are currently available in literature to support its association. We report a case of a 29-year-old woman who presented with severe hypertension. Work-up to exclude secondary hypertension showed high plasma renin activity, and imaging by ultrasound and computerized tomography a hydronephrosis and PUJO with impairment of kidney drainage at the renal scintigraphy. After double-J ureteric stenting, blood pressure decreased, antihypertensive medication tapered and the patients was normotensive with no antihypertensive medications after 6 months. We provide an update of the pathophysiology of hypertension in PUJO and a review of the available literature in order better to define the available treatments for these patients.