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Sydney Renal Services

Renal Consulting, Hypertension, Dialysis, Transplantation

FOR APPOINTMENTS, PLEASE CONTACT ROOMS NUMBERS AS BELOW Mail Address PO Box 113, auburn, NSW 1835

Who should be evauated for secondary hypertension ?

1.Severe or resistant hypertension (check compliance,Salt intake, etc..)

2.An acute rise in blood pressure over a previously stable value

3.Proven age of onset before puberty

4.Age less than 30 years with no family history of hypertension and no obesity

Renovascular ?

  1. An acute elevation in serum creatinine of at least 30 percent from baseline after administration of ACEI or ARB.
  2. Moderate to severe hypertension in a patient with atherosclerosis, with otherwise unexplained asymmetric renal size of (>1.5 cm)
  3. Recurrent episodes of flash pulmonary edema
  4. Onset of stage II hypertension after age 55 years
  5. Systolic or diastolic abdominal bruit (not very sensitive)

Renal Causes ?

Abnormal creatinine

Abnormal urinalysis

Phaeo ?

Paroxysmal hypertension with Triad of headache (usually pounding), palpitations, and sweating.

Conns ?

Unexplained hypokalemia with urinary potassium wasting

Unexplained Metabolic alkalosis (both are not common though)

Steroid induced?

Cushingoid facies, central adiposity, proximal muscle weakness, and ecchymoses

May have a history of glucocorticoid use or intrinsic steroid excess.

OSA ?

Obese snorers with daytime somnolence, fatigue, and morning confusion

Coarctation of Aorta ?

Asymmetric hypertension in the arms (R>L) or with diminished or delayed femoral pulses and low or unobtainable blood pressures in the legs.

OCPs, Hypothyroidism and Hyperparathyroidism

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