Two episodes of anuria and acute pulmonary edema in a losartan-treated patient with solitary kidney.
Atherosclerotic renal artery stenosis (RAS) is an increasingly important cause of end-stage kidney disease, and may cause hypertension, progressive renal failure, and recurrent pulmonary edema. Herein, we report two episodes of anuria and acute pulmonary edema associated with losartan treatment in a hypertensive patient with preexisting severe renal artery stenosis in a solitary kidney. After successful percutaneous renal balloon angioplasty procedure, urine flow was started immediately, despite 10 days of anuria. Blood pressure measurements were still at acceptable levels with a low dose Beta blocker, and serum creatinine levels were normal even after eight months. PTRA should be done in such patients, even with prolonged anuria. Physicians who recommend angiotensin receptor blockers in patients with RAS, especially in patients wih hypovolemia or a solitary kidney, should be careful about this complication.
Kiykim
Ahmet Alper
AA
Department of Internal Medicine, Division of Nephrology, Faculty of Medicine, University of Mersin, Ic hastaliklari Anabilim Dali Ogretim Uyesi, 33079 Mersin, Turkey. aakiykim@yahoo.com
Boz
Murat
M
Ozer
Caner
C
Camsari
Ahmet
A
Yildiz
Altan
A
D000328:Adult; D000959:Antihypertensive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001002:Anuria / Q000139:chemically induced*; D005260:Female; D006801:Humans; D006978:Hypertension, Renovascular / Q000150:complications / Q000188:drug therapy*; D019808:Losartan / Q000009:adverse effects* / Q000627:therapeutic use; D011654:Pulmonary Edema / Q000139:chemically induced*; D012078:Renal Artery Obstruction / Q000150:complications* / Q000188:drug therapy
D000959:Antihypertensive Agents; D019808:Losartan