Reversible acute renal failure induced by losartan in a renal transplant recipient.
A 56-year-old man who received a live-related renal transplant in 1988 was started in 1995 on the selective angiotensin II antagonist losartan (Dupont-Merke) to treat worsening hypertension. Two months later because of pulmonary oedema, loop diuretics were started. Within two weeks, serum creatinine had increased from 245 to 571 mumol/l, and the patient became oliguric. A systolic bruit was noted over the graft. Renal angiography showed a 90% stenosis of the transplant renal artery. Losartan was withdrawn, with prompt improvement in renal function. A successful percutaneous transluminal angioplasty performed a few days later resulted in further improvement in renal function accompanied by a significant diuresis.
Ostermann
M
M
Trafford Department of Renal Medicine, Royal Sussex County Hospital, Brighton, UK.
Goldsmith
D J
DJ
Doyle
T
T
Kingswood
J C
JC
Sharpstone
P
P
D058186:Acute Kidney Injury / Q000139:chemically induced* / Q000150:complications; D000800:Angioplasty, Balloon; D000959:Antihypertensive Agents / Q000009:adverse effects*; D001713:Biphenyl Compounds / Q000009:adverse effects*; D006801:Humans; D007093:Imidazoles / Q000009:adverse effects*; D016030:Kidney Transplantation; D019808:Losartan; D008297:Male; D008875:Middle Aged; D012078:Renal Artery Obstruction / Q000150:complications / Q000628:therapy; D013777:Tetrazoles / Q000009:adverse effects*
D000959:Antihypertensive Agents; D001713:Biphenyl Compounds; D007093:Imidazoles; D013777:Tetrazoles; D019808:Losartan