Ewha Med J.  2010 Mar;33(1):29-33. 10.12771/emj.2010.33.1.29.

Acute Renal Failure with Pulmonary Edema Induced by the Treatment of Angiotensin-Converting Enzyme Inhibitor and Angiotensin II Receptor Blocker in a Patient with Congenital Solitary Kidney

• Baek DH
• Kim KJ
• Hong SC
• Kang SH
• Song HE
• Kim HI
• Kim SH
• Oh HJ
• Kang HW
• Kim SW
• Yu MA
• Ryu DR
• Choi KB
• Kang DH

• KMID: 1907772
• DOI: http://doi.org/10.12771/emj.2010.33.1.29

Abstract

Blockers of renin-angiotensin system(RAS) including ACE inhibitor or ARB are one of the most frequently prescribed medications for the treatment of hypertension, heart failure and proteinuria. One of the major side effects of these RAS blockers is the deterioration of renal function, mainly due to a reduction of intraglomerular pressure. Therefore, close monitoring of renal function is recommended when RAS blockers are initially prescribed, especially for the patients with impaired renal function. We report a patient who was transferred to our hospital due to the sudden development of oliguria and dyspnea after treatment for hypertension with ACEi and ARB. She was finally diagnosed as RAS blocker-induced acute renal failure with pulmonary edema complicated on congenital solitary kidney. After hemodialysis and conservative treatment, her renal function was recovered with maintenance of normal urine output.
CONCLUSION
This case highlights the necessity of the functional and structural evaluation of kidney to prevent the serious complication such as acute renal failure before the administration of ACEi and/or ARB.

Keyword

Acute kidney failure; pulmonary edema; Angiotensin-converting enzyme Inhibitors; Angiotensin II Type 1 receptor blockers; Congenital solitary kidney

MeSH Terms

Acute Kidney Injury*
Angiotensin II Type 1 Receptor Blockers
Angiotensin-Converting Enzyme Inhibitors
Dyspnea
Heart Failure
Humans
Hypertension
Kidney*
Oliguria
Proteinuria
Pulmonary Edema*
Receptors, Angiotensin*
Renal Dialysis
Angiotensin II Type 1 Receptor Blockers
Angiotensin-Converting Enzyme Inhibitors
Receptors, Angiotensin