Captopril-induced acute reversible renal failure.
We report 5 cases of acute reversible renal failure coinciding with the onset of treatment with captopril in patients with severe drug-resistant hypertension. There was no clinical or laboratory evidence for an immunologic or toxic insult, although in 1 patient we found a transient leukocyturia and mild proteinuria. A mere hypoperfusion of the kidney does not seem sufficient to account for all 5 observations: in 3 of them changes in blood pressure did not parallel changes in renal function. We propose that, in addition to hyperperfusion, captopril alters renal function by an additional intrarenal hemodynamic effect. The 5 patients had severe renovascular disease which might thus represent a significant risk factor in the development of captopril-induced acute renal failure.
D058186:Acute Kidney Injury / Q000139:chemically induced*; D000328:Adult; D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D002216:Captopril / Q000009:adverse effects*; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D007668:Kidney / Q000098:blood supply; D008297:Male; D011392:Proline / Q000031:analogs & derivatives*
D011392:Proline; D002216:Captopril