Hypertension secondary to massive upper pole hydronephrosis

Hypertension secondary to hydronephrosis is uncommon, and when a duplex system is involved it is rare. A patient presenting with hypertension and an abdominal mass on the left side was found to have a non-functioning, massively dilated upper pole of a duplex system causing hyperreninemic hypertension. Treatment consisted of an upper pole partial nephrectomy. This unique case is discussed and the literature regarding hypertension secondary to hydronephrosis is reviewed.