Occlusion of unilateral stenosed renal arteries--relation to medical treatment.
In 78 patients we studied retrospectively the occurrence of occlusion in unilateral renal artery stenosis during antihypertensive drug treatment. Complete occlusion occurred in 14 patients (18%). In a multivariate analysis the following characteristics were included: blood pressure, aetiology of the stenosis, serum creatinine, the degree of the stenosis, anti-hypertensive medication, standing renal vein renin ratio and age. In this analysis the combination of a diuretic and an ACE-inhibitor, during the observation period, showed an independent relation to the development of an occlusion (P less than 0.05). Also the ACE-inhibitor alone showed a relation (P = 0.06). In the 14 patients who developed an occlusion only three showed a significant rise in serum creatinine. We conclude that special attention should be given to the follow-up of patients with renal artery stenosis who have ACE-inhibitors in their treatment regimen, especially when in combination with a diuretic.
Department of Medicine, University Hospital, Nijmegen, The Netherlands.
C T
CT
Postma
W H
WH
Hoefnagels
J O
JO
Barentsz
T
T
de Boo
T
T
Thien
D000293:Adolescent; D000328:Adult; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage / Q000009:adverse effects; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001794:Blood Pressure / Q000187:drug effects; D003404:Creatinine / Q000097:blood; D004232:Diuretics / Q000008:administration & dosage / Q000009:adverse effects; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006978:Hypertension, Renovascular / Q000188:drug therapy* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012078:Renal Artery Obstruction / Q000139:chemically induced* / Q000150:complications; D012189:Retrospective Studies
D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D004232:Diuretics; D003404:Creatinine