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Park HJ, Jang HN, Cho HS, Chang SH, Kim HJ. A case report of successfully treated nephrotic syndrome after renal angioplasty. BMC Nephrol 2019; 20:305. [PMID: 31387536 PMCID: PMC6685235 DOI: 10.1186/s12882-019-1503-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 07/29/2019] [Indexed: 11/12/2022] Open
Abstract
Background The standard treatment of renovascular hypertension accompanying renal artery stenosis (RAS) consists of angioplasty and administration of antihypertensive medication. Although nephrotic syndrome (NS) has been reported to be associated with RAS, the development of NS after revascularization of RAS is extremely rare. Case presentation A 48-year-old man presented with uncontrolled hypertension and azotemia. The right kidney was atrophic, and RAS of the left kidney was suspected based on a post-captopril DTPA scan. His blood pressure stabilized after renal angioplasty; however, he complained of edema after 1 week. NS developed and was diagnosed as focal segmental glomerulosclerosis (FSGS) based on renal biopsy. He received an angiotensin receptor blocker. Proteinuria resolved after 1 year. Conclusions FSGS rarely develops after angioplasty of renal artery stenosis. This is the first report of successful treatment of this condition using an angiotensin receptor blocker during 1-year follow-up.
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Affiliation(s)
- Hee Jung Park
- Division of Nephrology, Department of Internal Medicine, Gyeongsang National University Hospital, Jinju, South Korea
| | - Ha Nee Jang
- Division of Nephrology, Department of Internal Medicine, Gyeongsang National University Hospital, Jinju, South Korea
| | - Hyun Seop Cho
- Division of Nephrology, Department of Internal Medicine, Gyeongsang National University Hospital, Jinju, South Korea.,Department of Internal Medicine, College of Medicine, Gyeongsang National University, Jinju, South Korea.,Institute of Health Sciences, Gyeongsang National University, Jinju, South Korea
| | - Se-Ho Chang
- Division of Nephrology, Department of Internal Medicine, Gyeongsang National University Hospital, Jinju, South Korea.,Department of Internal Medicine, College of Medicine, Gyeongsang National University, Jinju, South Korea.,Institute of Health Sciences, Gyeongsang National University, Jinju, South Korea
| | - Hyun-Jung Kim
- Division of Nephrology, Department of Internal Medicine, Gyeongsang National University Hospital, Jinju, South Korea. .,Department of Internal Medicine, College of Medicine, Gyeongsang National University, Jinju, South Korea. .,Institute of Health Sciences, Gyeongsang National University, Jinju, South Korea.
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Toda H, Uchida H, Nakamura K, Takeuchi H, Kinomura M, Nakagawa K, Watanabe A, Miyoshi T, Nishii N, Morita H, Wada J, Ito H. Combination of Renal Angioplasty and Angiotensin-converting-enzyme Inhibitor Can Reduce Proteinuria in Patients with Bilateral Renal Artery Disease. Intern Med 2019; 58:1917-1922. [PMID: 30799351 PMCID: PMC6663532 DOI: 10.2169/internalmedicine.2076-18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Recent large clinical trials failed to show clear benefits of percutaneous transluminal renal angioplasty (PTRA) as compared with medical therapy on patients with renal artery stenosis. It was also reported that proteinuria is an adverse prognostic factor after PTRA, and PTRA is less effective in patients with overt proteinuria. From the renoprotective point of view, to reduce proteinuria after PTRA is an important therapeutic goal in patients with renal artery stenosis with overt proteinuria. We hereby describe two patients successfully treated by combination therapy with PTRA and administration of angiotensin-converting enzyme (ACE) inhibitor for bilateral renal artery disease with overt proteinuria.
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Affiliation(s)
- Hironobu Toda
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
| | - Haruhito Uchida
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
- Department of Chronic Kidney Disease and Cardiovascular Disease, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
| | - Kazufumi Nakamura
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
| | - Hidemi Takeuchi
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
| | - Masaru Kinomura
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
| | - Koji Nakagawa
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
| | - Atsuyuki Watanabe
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
| | - Toru Miyoshi
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
| | - Nobuhiro Nishii
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
| | - Hiroshi Morita
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
- Department of Cardiovascular Therapeutics, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan
| | - Jun Wada
- Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
| | - Hiroshi Ito
- Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan
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