[Benefits of a beta-blocking agent (carvedilol) on bilateral atherosclerotic renal artery stenosis. A case report].
A 77 year old man with coronary artery disease was referred to our institution for recurrent (flash) episodes of pulmonary edema due to malignant hypertension. A selective contrast-enhanced angiography showed severe bilateral renal artery stenosis. We also found a high level of plasma renin production identifying intense renin-angiotensin system activation. We first considered revascularisation. Percutaneous intervention initially failed and thereafter the patient denied surgical revascularisation. We have then recommended medical therapy, namely a beta-blocker after adequate correction of fluid retention. We used CARVEDILOL which has no nephrotoxicity and effectively inhibit the renin-angiotensin system. The patient feels significant functional and clinical improvement with no fluid retention relapse with a follow-up of more than 18 months.
Massing
J L
JL
Service de cardiologie, hôpital Sainte-Blandine, 3, rue du Cambout, 57045 metz, France. massing.jean-luc@wanadoo.fr
Baille
N
N
Raddad
M
M
Gangloff
C
C
Lecourtois
P
P
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000368:Aged; D002227:Carbazoles / Q000627:therapeutic use*; D000077261:Carvedilol; D003324:Coronary Artery Disease / Q000150:complications; D006801:Humans; D006974:Hypertension, Malignant / Q000150:complications; D008297:Male; D011412:Propanolamines / Q000627:therapeutic use*; D012078:Renal Artery Obstruction / Q000175:diagnosis / Q000188:drug therapy*
D000319:Adrenergic beta-Antagonists; D002227:Carbazoles; D011412:Propanolamines; D000077261:Carvedilol