Renal hyperperfusion injury resulting in transient proteinuria post renal artery angioplasty for fibromuscular dysplasia

Renovascular hypertension (RVH) can be treated utilizing medical, surgical or endovascular techniques. We present a case in which severe exacerbation of pre-existing proteinuria followed percutaneous transluminal angioplasty of a highly stenotic renal artery to relieve RVH caused by fibromuscular dy...

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Bibliographic Details
Published in:Pediatric radiology 2012-04, Vol.42 (4), p.491-494
Main Authors: Heran, Manraj K. S., Sangha, Bippan S., White, Colin
Format: Article
Language:English
Subjects:
Adolescent
Angioplasty - adverse effects
Case Report
Female
Fibromuscular Dysplasia - complications
Fibromuscular Dysplasia - surgery
Humans
Hypertension, Renal - diagnosis
Hypertension, Renal - etiology
Imaging
Medicine
Medicine & Public Health
Neuroradiology
Nuclear Medicine
Oncology
Pediatrics
Radiology
Renal Artery - surgery
Renal Artery Obstruction - etiology
Renal Artery Obstruction - surgery
Ultrasound
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Summary:Renovascular hypertension (RVH) can be treated utilizing medical, surgical or endovascular techniques. We present a case in which severe exacerbation of pre-existing proteinuria followed percutaneous transluminal angioplasty of a highly stenotic renal artery to relieve RVH caused by fibromuscular dysplasia. We propose that the worsening proteinuria post-angioplasty was caused by a transient renal hyperperfusion injury that overcame the glomerular autoregulatory mechanisms, thereby leading to raised intraglomerular pressures and loss of proteins through the glomerular filtration barrier until the vascular autoregulatory ability of the glomeruli was successfully re-established.
ISSN:0301-0449
1432-1998
DOI:10.1007/s00247-011-2207-z