title: Acute tubular necrosis in kidney transplant patients treated with enalapril.
abstract: We report two cases of acute renal failure in renal transplant patients using cyclosporine-A (CsA) after the introduction of angiotensin-converting enzyme inhibitor (ACEI) to control arterial hypertension. They had no renal artery stenosis or acute rejection. Both patients presented severe acute tubular necrosis (ATN), which subsided after discontinuation of the ACEI. Synergistic toxic effect of ACEI and CsA on the renal tubules might explain ATN in these two cases.
authors.affiliation: Renal Transplant Unit, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
authors.forename: T M
authors.initials: TM
authors.lastname: Garcia
authors.forename: J A
authors.initials: JA
authors.lastname: da Costa
authors.forename: R S
authors.initials: RS
authors.lastname: Costa
authors.forename: A S
authors.initials: AS
authors.lastname: Ferraz
mesh_terms: D016572:Cyclosporine / Q000009:adverse effects / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004357:Drug Synergism; D004656:Enalapril / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D016030:Kidney Transplantation; D007683:Kidney Tubular Necrosis, Acute / Q000139:chemically induced*; D007684:Kidney Tubules / Q000187:drug effects; D008297:Male; D008875:Middle Aged
chemical_list: D004656:Enalapril; D016572:Cyclosporine