End-stage renal failure after irbesartan prescription in a diabetic patient with previously stable chronic renal insufficiency.
We report the case of a 78-year-old hypertensive diabetic patient without evidence of renal artery stenosis who had moderate chronic renal insufficiency, which had been stable for several years under low-dose captopril therapy, and who rapidly developed acute renal failure when irbesartan was prescribed. Unfortunately the medication was not stopped promptly and the patient never recovered his basal renal function and had to undergo chronic hemodialysis. This observation emphasizes the importance of a careful monitoring of renal function in patients receiving angiotensin II receptor antagonists.
Descombes
E
E
Department of Internal Medicine, Hôpital Cantonal, Fribourg, Switzerland. descombese@hopcantfr.ch
Fellay
G
G
D000368:Aged; D057911:Angiotensin Receptor Antagonists; D000959:Antihypertensive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001713:Biphenyl Compounds / Q000009:adverse effects* / Q000627:therapeutic use; D002216:Captopril / Q000627:therapeutic use; D003928:Diabetic Nephropathies / Q000188:drug therapy*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D000077405:Irbesartan; D007676:Kidney Failure, Chronic / Q000139:chemically induced* / Q000188:drug therapy*; D008297:Male; D013777:Tetrazoles / Q000009:adverse effects* / Q000627:therapeutic use
D057911:Angiotensin Receptor Antagonists; D000959:Antihypertensive Agents; D001713:Biphenyl Compounds; D013777:Tetrazoles; D002216:Captopril; D000077405:Irbesartan