Peripheral artery disease: a cause of refractory hypertension after renal transplantation.
The authors report the case of a 44-year-old man, with a history of hypertension, smoking, peripheral artery disease and chronic renal failure. After renal transplantation, the patient developed persistent high blood pressure, despite optimal medical therapy. When angiotensin-converting enzyme (ACE) inhibitor therapy was begun, he developed acute anuric renal failure, which was reversed after interruption of the ACE inhibitor. After the initial clinical evaluation, the patient was referred for renal angiography, which revealed critical stenosis of the proximal left common iliac artery, just above the renal graft artery anastomosis. The patient underwent successful angioplasty and stenting of the lesion, with complete normalization of blood pressure.
Serviço de Cardiologia, Hospital de Santa Cruz, Carnaxide, Portugal. raqueldourado@yahoo.com
Raquel
R
Dourado
Pedro de Araújo
Pde A
Gonçalves
Manuel
M
Almeida
André
A
Weigert
Margarida
M
Bruges
Augusta
A
Gaspar
Acácio Pita
AP
Negrão
Domingos
D
Machado
Belarmino
B
Clemente
Rui
R
Teles
Francisco Pereira
FP
Machado
Aniceto
A
Silva
D000714:Anastomosis, Surgical / Q000009:adverse effects; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001157:Arterial Occlusive Diseases / Q000150:complications*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000209:etiology*; D007083:Iliac Artery; D007676:Kidney Failure, Chronic / Q000150:complications / Q000601:surgery; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000150:complications; D011183:Postoperative Complications
D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents