A client with a diagnosis of chronic renal failure secondary to diabetes has seen a gradual increase ...

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Renovascular hypertension refers to hypertension caused by reduced renal blood flow and activation of the reninangiotensinaldosterone mechanism. It is the most common cause of secondary hypertension, accounting for 1 to 2 of all cases of hypertension. The reduced renal blood flow that occurs with renovascular disease causes the affected kidney to release excessive amounts of renin, increasing circulating levels of angiotensin II. Angiotensin II, in turn, acts as a vasoconstrictor to increase peripheral vascular resistance and as a stimulus for increased aldosterone levels and sodium retention by the kidney. One or both of the kidneys may be affected. A renal etiology is not associated with secondary hypertension due to hormonal factors, sympathetic stimulation, or coarctation of the aorta.

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