Malignant hypertension. Recovery of kidney function after renal allograft failure.
A 28-year old patient with malignant hypertension developed endstage renal failure necessitating chronic maintenance hemodialysis for seven months and transplantation of a renal allograft that was rejected within a month. After this, with continued control of the hypertension, the patient's own kidneys gradually resumed function and achieved anendogenous creatinine clearance of 30 ml/min. She has not required further dialysis for more than nine months. Recovery of sufficient renal function to maintain homeostasis, one year after onset of uremia, indicates the prolonged antihypertensive treatment period that may be necessary to reverse the renal arteriolar changes associated with malignant hypertension. This experience further underlines the necessity of moderation in the use of nephrectomy in the management of severe hypertension.
D000328:Adult; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001806:Blood Urea Nitrogen; D003404:Creatinine / Q000097:blood; D005260:Female; D006084:Graft Rejection; D006801:Humans; D006974:Hypertension, Malignant / Q000150:complications* / Q000188:drug therapy; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007668:Kidney / Q000503:physiopathology; D007676:Kidney Failure, Chronic / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D016030:Kidney Transplantation; D007710:Klebsiella Infections / Q000188:drug therapy; D012075:Remission, Spontaneous; D006435:Renal Dialysis; D014184:Transplantation, Homologous; D014552:Urinary Tract Infections / Q000188:drug therapy
D000959:Antihypertensive Agents; D007166:Immunosuppressive Agents; D003404:Creatinine