Nefropatia isquêmica

Salame, Marcelo; Padulla, Geórgia Andrade; Muradás, Raquel Rodrigues; Machado, Gabriela; Braun, Stela Karine; Santos, Karine Rabuske dos; Mussio, Alexandre Valério; Konopka, Clóvis Luís

doi:10.1590/s1677-54492012000400010

Cited by 1 publication

(1 citation statement)

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“…The perpetuation of this mechanism induces renal fibrosis, with glomerular hyalinization and progressive kidney atrophy. 18 Renovascular disease may be treated clinically, surgically, or by percutaneous procedures (with or without stent grafts). Calcium channel blockers, angiotensin-converting-enzyme inhibitors, angiotensin II type 1 receptor blockers, and beta blockers have been effectively used to treat systemic hypertension associated with renal artery stenosis.…”

Section: Discussionmentioning

confidence: 99%

Takayasu arteritis: differential diagnosis in a teenager with severe acute kidney injury - a case report

et al. 2019

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Takayasu arteritis (TA) is a chronic granulomatous inflammatory condition of unknown cause that involves large vessels - particularly the aorta and its branches - such as the carotid, coronary, pulmonary, and renal arteries. The left subclavian artery is the most frequently involved vessel. Stenosis of the renal artery has been reported in 23-31% of the cases and may result in malignant hypertension, ischemic renal disease, decompensated heart failure, and premature death. Involvement of both renal arteries is uncommon. Early onset anuria and acute kidney injury are rare and have been reported only in a few cases in the literature. This report describes the case of a 15-year-old female with constitutional symptoms evolving for a year, combined with headache, nausea, and vomiting, in addition to frequent visits to emergency services and insufficient clinical examination. The patient worsened significantly six months after the onset of symptoms and developed acute pulmonary edema, oliguria, acute kidney injury, and difficult-to-control hypertension, at which point she was admitted for intensive care and hemodialysis. Initial ultrasound examination showed she had normal kidneys and stenosis-free renal arteries. The patient was still anuric after 30 days of hospitalization. A biopsy was performed and revealed her kidneys were normal. Computed tomography angiography scans of the abdominal aorta presented evidence of occlusion of both renal arteries. The patient met the diagnostic criteria for Takayasu arteritis and had a severe complication rarely described in the literature: stenosis of the two renal arteries during the acute stage of ischemic renal disease.

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Section: Discussionmentioning

confidence: 99%