Kidney Res Clin Pract.  2016 Jun;35(2):119-122. 10.1016/j.krcp.2015.08.006.

Renal artery stenosis presenting with nephrotic-range proteinuria: a case report

• Hwang S
• Ham JS
• Hwang KB
• Jeong SH
• Ha SH
• Koo EH
• Kwon GY
• Do YS
• Jang HR

• KMID: 2311833
• DOI: http://doi.org/10.1016/j.krcp.2015.08.006

Abstract

Renal artery stenosis (RAS) is commonly presented with hypertension and chronic kidney disease. We report a rare case of RAS occurring in a 78-year-old man who presented with nephrotic-range proteinuria. Renal biopsy on the left side was performed, and results showed mesangiopathic glomerulonephritis, which was not compatible with the cause of nephrotic-range proteinuria. Proteinuria was decreased by angiotensin receptor blocker, but azotemia was aggravated. Therefore, angiotensin receptor blocker was discontinued inevitably and thorough evaluation for the possibility of RAS was performed. Computed tomography angiography revealed significant RAS on the left side and a renal artery stent was inserted. After stenting, aortic dissection developed and progressed despite tight control of blood pressure. After inserting another stent graft through the true lumen of the left renal artery, the patient's renal function and proteinuria improved markedly.

Keyword

Angioplasty; Proteinuria; Renal artery stenosis; Stent

MeSH Terms

Aged
Angiography
Angioplasty
Angiotensins
Azotemia
Biopsy
Blood Pressure
Blood Vessel Prosthesis
Glomerulonephritis
Humans
Hypertension
Proteinuria*
Renal Artery Obstruction*
Renal Artery*
Renal Insufficiency, Chronic
Stents
Angiotensins