[Renal insufficiency after administration of captopril in renal artery stenosis with a single kidney or bilateral stenosis is not compulsory].
Acute renal failure has been reported during captopril therapy of hypertension due to renal artery stenosis with a single kidney or bilateral renal artery stenosis. Under low perfusion pressures inhibition of the renin-angiotensin system could disturb the autoregulation, decrease efferent arteriolar resistance and lead to a critical decrease in glomerular filtration. Renal function tests were repeated in a patient with hypertension due to 90 p. 100 renal artery stenosis with a single kidney, before and after captopril administration (sodium intake 100 mmol/24 h). (table; see text) Identical results have also been observed in a patient with bilateral renal artery stenosis. Both patients presented high risk renal haemodynamic states. The control of systemic blood pressure and the fall in filtration fraction were not associated with a critical, immediate or short term fall in glomerular filtration. The isolated administration of captopril is therefore not systematically contra-indicated in these two clinical situations.
D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000503:physiopathology; D000293:Adolescent; D000328:Adult; D002216:Captopril / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D006978:Hypertension, Renovascular / Q000188:drug therapy*; D008297:Male; D011392:Proline / Q000031:analogs & derivatives*; D012078:Renal Artery Obstruction / Q000188:drug therapy
D011392:Proline; D002216:Captopril
L'insuffisance rénale après administration de captopril dans les sténoses de l'artère rénale sur rein unique ou les sténoses bilatérales n'est pas obligatoire.