Renal graft failure after addition of an angiotensin II receptor antagonist to an angiotensin-converting enzyme inhibitor: unmasking of an unknown iliac artery stenosis.
Combined treatment with an angiotensin-converting enzyme (ACE) inhibitor and an angiotensin II (Ang II) receptor blocker (ARB) has been suggested in order to achieve a more complete blockade of the renin-angiotensin-aldosterone system in cardiovascular and renal disease. The present report describes a case of acute renal graft dysfunction following the addition of an ARB to existing ACE inhibition. This unmasked an unknown iliac artery stenosis. The case indicates a possible important role of Ang II generated by non-ACE pathways in this situation.
Kamper
Anne-Lise
AL
Department of Nephrology, Herlev Hospital, Denmark. ankam@herlevhosp.kbhamt.dk
Nielsen
Arne Høj
AH
Baekgaard
Niels
N
Just
Svend
S
D000792:Angiography; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D001157:Arterial Occlusive Diseases / Q000473:pathology*; D003251:Constriction, Pathologic; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D007083:Iliac Artery / Q000473:pathology*; D016030:Kidney Transplantation; D008875:Middle Aged; D017211:Treatment Failure
D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors