title: [Acute renal insufficiency secondary to the use of angiotensin converting enzyme inhibitors in 2 patients without renal artery stenosis].
abstract: Two female patients who developed acute renal failure secondary to the use of angiotensin converting enzyme (ACE) inhibitors for hypertension are presented. None had renal artery stenosis on angiography or duplex doppler ultrasound examination. A 66 year old patient with a single functioning kidney recovered basal renal function; the other patient, aged 77 years, remained with a permanent severe renal damage. Risk factors were advanced age, mild chronic renal failure due to nephrosclerosis and diuretic use. We conclude that acute renal failure related to ACE inhibitors may be severe and can occur even in patients without renal artery stenosis. Diuretics, associated to ACE inhibitors, should be prescribed with caution, specially in older hypertensive patients with pre-existing chronic renal failure. Diabetic patients are at special risk due to the high incidence of small vessel disease in them.
authors.affiliation: Servicio de Medicina, Hospital Naval de Valparaíso, Chile.
authors.forename: J
authors.initials: J
authors.lastname: Duclos
authors.forename: J
authors.initials: J
authors.lastname: Ruiz
authors.forename: B
authors.initials: B
authors.lastname: Sánchez
authors.forename: S
authors.initials: S
authors.lastname: Rendich
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced*; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects*; D005260:Female; D006801:Humans; D012078:Renal Artery Obstruction
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors
vernacular_title: Insuficiencia renal aguda secundaria a inhibidores de la enzima convertidora de angiotensina en dos pacientes sin estenosis de arterias renales.