Reversible anuric acute kidney injury secondary to acute renal autoregulatory dysfunction.
Autoregulation of glomerular capillary pressure via regulation of the resistances at the afferent and efferent arterioles plays a critical role in maintaining the glomerular filtration rate over a wide range of mean arterial pressure. Angiotensin II and prostaglandins are among the agents which contribute to autoregulation and drugs which interfere with these agents may have a substantial impact on afferent and efferent arteriolar resistance. We describe a patient who suffered an episode of anuric acute kidney injury following exposure to a nonsteroidal anti-inflammatory agent while on two diuretics, an angiotensin-converting enzyme inhibitor, and an angiotensin receptor blocker. The episode completely resolved and we review some of the mechanisms by which these events may have taken place and suggest the term "acute renal autoregulatory dysfunction" to describe this syndrome.
Department of Medicine, Winthrop-University Hospital , Mineola, NY , USA.
Louis J
LJ
Imbriano
John K
JK
Maesaka
James
J
Drakakis
Joseph
J
Mattana
D058186:Acute Kidney Injury / Q000139:chemically induced*; D047228:Angiotensin II Type 1 Receptor Blockers / Q000009:adverse effects*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects*; D001002:Anuria / Q000139:chemically induced*; D019645:Arthroplasty, Replacement, Knee; D004232:Diuretics / Q000009:adverse effects*; D004359:Drug Therapy, Combination / Q000009:adverse effects; D005260:Female; D006706:Homeostasis / Q000187:drug effects; D006801:Humans; D017706:Lisinopril / Q000009:adverse effects; D008875:Middle Aged; D011183:Postoperative Complications / Q000139:chemically induced
D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D004232:Diuretics; D017706:Lisinopril