Reversible acute renal failure induced by losartan in a renal transplant recipient

A 56-year-old man who received a live-related renal transplant in 1988 was started in 1995 on the selective angiotensin II antagonist losartan (Dupont-Merke) to treat worsening hypertension. Two months later because of pulmonary oedema, loop diuretics were started. Within two weeks, serum creatinine...

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Bibliographic Details
Published in:Postgraduate medical journal 1997-02, Vol.73 (856), p.105-107
Main Authors: Ostermann, M., Goldsmith, D. J., Doyle, T., Kingswood, J. C., Sharpstone, P.
Format: Article
Language:English
Subjects:
Acute Kidney Injury - chemically induced
Acute Kidney Injury - complications
Angioplasty, Balloon
Antihypertensive Agents - adverse effects
Biological and medical sciences
Biphenyl Compounds - adverse effects
Humans
Imidazoles - adverse effects
Kidney Transplantation
Losartan
Male
Medical sciences
Middle Aged
Renal Artery Obstruction - complications
Renal Artery Obstruction - therapy
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the urinary system
Tetrazoles - adverse effects
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Summary:A 56-year-old man who received a live-related renal transplant in 1988 was started in 1995 on the selective angiotensin II antagonist losartan (Dupont-Merke) to treat worsening hypertension. Two months later because of pulmonary oedema, loop diuretics were started. Within two weeks, serum creatinine had increased from 245 to 571 mumol/l, and the patient became oliguric. A systolic bruit was noted over the graft. Renal angiography showed a 90% stenosis of the transplant renal artery. Losartan was withdrawn, with prompt improvement in renal function. A successful percutaneous transluminal angioplasty performed a few days later resulted in further improvement in renal function accompanied by a significant diuresis.
ISSN:0032-5473
1469-0756
DOI:10.1136/pgmj.73.856.105