Reversible dialysis-dependent renal failure due to undiagnosed renovascular disease

Abstract

Renovascular disease (RVD) can present with resistant hypertension, acute or rapidly progressive renal failure and occasionally nephrotic proteinuria. Revascularization plays an important role in controlling blood pressure and preserving renal function. It is widely believed that delay in revascularization would result in irreversible loss of renal function. However, we report a favorable outcome despite delayed revascularization in two patients of RVD- one presenting with recurrent flash pulmonary edema and other with progressive renal failure. The former's serum creatinine returned to normal despite 3 months of anuria and the latter became dialysis-independent despite 2 months of progressive decline in renal function. Both remain dialysis-free 3 years after surgery.

Renal salvage using stent graft placement after acute renal artery occlusion with prolonged ischemic time

“…13 Evidence for the achievement of hemodialysis independence after renal revascularization is scant in literature; nevertheless, there have been reports of previously dialysis-dependent patients achieving independence after revascularization procedures. 14,15 Better renal function preservation and outcomes have been reported for patients with acute renal embolism when collateral perfusion to the renal parenchyma is preserved. 16,17 Our case presents a unique perspective and challenges the conventional wisdom regarding renal revascularization for RAO in the setting of chronic atherosclerotic disease.…”