Case ReportsTreatment of acute renal failure caused by renal artery occlusion with renal artery angioplasty
Section snippets
Case 1
A 61-year-old woman had a history of right renal artery stenting 2 years prior for hypertension. A small left kidney was noted. Comorbidities included type 2 diabetes mellitus, hypertension, and hypercholesterolemia. Baseline serum creatinine was 1.5 mg/dL (0.13 mmol/L). She was not treated with an ACE inhibitor. She presented with uremic symptoms after a diarrheal illness. Her urine output was 500 mL/d despite adequate volume replacement with serum creatinine of 6.1 mg/dL (0.54 mmol/L). She
Discussion
ARVD is a common cause of renal impairment and hypertension9 in the elderly population (median age, 60 to 70 years).11, 12, 13 High-risk patients are those who have clinical manifestations of atheroma at extrarenal sites, such as the aorta or cardiac, cerebral, or peripheral circulations.11, 12, 14, 15 The prevalence of ARVD was reported as 25% in patients having routine coronary angiography and 50% in patients having peripheral angiography.2, 4, 5, 6, 7, 9, 15, 16 Lesions are bilateral in 50%
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Cited by (25)
Ischemic Renal Disease
2013, Seldin and Geibisch's The KidneyIschemic Renal Disease
2012, Seldin and Giebisch's The Kidney: Physiology and PathophysiologyRenal failure: Diagnostic work-up
2011, Journal de RadiologieAnuric acute renal failure and pulmonary oedema: A case for urgent action
2009, International Journal of CardiologyCitation Excerpt :Patients with ARVD may develop ARF in association with cholesterol atheroemboli, hypovolemia induced acute tubular necrosis, contrast nephropathy but the commonest presentation is with concomitant ACE-I or ARB use in patients with bilaterally significant RAS or in previously stable RAS patients who become hypovolaemic. Anuric ARF rarely complicates ARVD [2,7] but when it does it is most often associated with acute RAO as a result of thrombosis or with a critical stenosis with/without the effects of ACE-I or ARBs. In order for the anuria to supervene this pathology is likely to be bilateral or present in a previously solitary functioning kidney (as in our case).
Renal Arteries and Veins
2006, Vascular and Interventional Radiology, Second EditionSalvage stenting for acute renal failure secondary to renal artery stenosis
2003, Heart Lung and Circulation
Address reprint requests to Karen M. Dwyer, MB, BS, FRACP, Department of Nephrology, 41 Victoria Parade, Fitzroy, 3065, Victoria, Australia. E-mail: [email protected]