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Captopril Therapy Following Percutaneous Transluminal Angioplasty for Bilateral Renal Artery Stenosis

Captopril Therapy Following Percutaneous Transluminal Angioplasty for Bilateral Renal Artery... Abstract • To establish an optimal approach for the patients with bilateral atherosclerotic renal artery stenosis, combined treatment involving percutaneous transluminal renal angioplasty and oral captopril was applied. Five patients were examined for effects of the combined treatment on blood pressure and renal function. After percutaneous transluminal renal angioplasty on one renal artery, the blood pressure (mean ± SD) fell from 210/118 26/8 to 176/104 11/9mm Hg without any deterioration of renal function. This reduced blood pressure was further lowered to 155/92 ± 6/3 mm Hg by adding captopril therapy. This level of blood pressure has been maintained for an average of 37 months. Significant increases in serum creatinine concentration were not observed (124 27 vs 141 44 μmol/L), and renal size has been sustained. These results indicate that combined treatment with percutaneous transluminal renal angioplasty and captopril is effective in reducing the blood pressure and preserving renal function as an approach for the patients with bilateral atherosclerotic renal artery stenosis. (Arch Intern Med. 1989;149:1973-1976) References 1. Aldigier JC, Plouin PF, Guyene TT, Thibonnier M, Corvol P, Menard J. Comparison of the hormonal and renal effects of captopril in severe essential andrenovascularhypertension . Am J Cardiol . 1982;49:1447-1452.Crossref 2. Reams GP, Bauer JH, Gaddy P. Use of the converting enzyme inhibitor enalapril in renovascular hypertension: effect on blood pressure, renal function, and the renin-angiotensin-aldosterone system . Hypertension . 1986;8:290-297.Crossref 3. Dean RH, Oates JA, Wilson JP, et al. Bilateral renal artery stenosis and renovascular hypertension . Surgery . 1977;81:53-62. 4. Lawrie GM, Morris GC Jr, Soussou ID, et al. Late results of reconstructive surgery for renovascular disease . Ann Surg . 1980;191:528-533.Crossref 5. Sos TA, Pickering TG, Sniderman K, et al. Percutaneous transluminal renal angioplasty in renovascular hypertension due to atheroma or fibromusculardysplasia . N Engl J Med . 1983;309:274-279.Crossref 6. Geyskes GG, Puylaert CBAJ, Oei HY, Mees EJD. Follow-up study of 70 patients with renal artery stenosis treated by percutaneous transluminal dilatation . Br Med J. 1983;287:333-336.Crossref 7. Tegtmeyer CJ, Kellum CD, Ayers C. Percutaneous transluminal angioplasty of the renal artery: results and long-term follow-up . Radiology . 1984;153:77-84.Crossref 8. Kuhlmann U, Greminger P, Gruentzig A, et al. Long-term experience in percutaneous transluminal dilatation of renal artery stenosis . Am J Med . 1985;79:692-698.Crossref 9. Schreiber MJ, Pohl MA, Novick AC. The natural history of atherosclerotic and fibrous renal artery disease . Urol Clin North Am . 1984;11:383-392. 10. Chrysant SG, Dunn M, Marples D, DeMasters K. Severe reversible azotemia from captopril therapy: report of three cases and review of the literature . Arch Intern Med . 1983;143:437-441.Crossref 11. Hricik DE, Browning PJ, Kopelman R, Goorno WE, Madias NE, Dzau VJ. Captopril-induced functional renal insufficiency in patients with bilateral renal-artery stenoses or renal-artery stenosis in a solitary kidney . N Engl J Med . 1983;308:373-376.Crossref 12. Hoorntje SJ, Donker AJM, Schuur KH, Boomsma JHB. Renal artery dilatation in a patient on captopril: changing a 'two-kidney, two-clip hypertension' into a 'two-kidney, one-clip hypertension.' Nephron . 1982;30:56-59.Crossref 13. Narimatsu Y, Tanimoto A, Kohda E, Hisa N, Iwata Y, Hiramatsu K. Percutaneous transluminal angioplasty in renovascular hypertension: long-term follow-up . Nippon Acta Radiol . 1986;46:585-594. 14. Maxwell MH, Bleifer KH, Franklin SS, Varady PD, Deegan C. Cooperative study of renovascular hypertension: demographic analysis of the study . JAMA . 1972;220:1195-1204.Crossref 15. Swinton NW Jr, Breslin DJ, Libertino JA, Zinman L. Renovascular hypertension: therapeutic decisions and results . In: Breslin DJ, Swinton NW Jr, Libertino JA, Zinman L, eds. Renovascular Hypertension . Baltimore, Md: Williams & Wilkins; 1982:213-221. 16. Dean RH, Hollifield JW, Oates JA. Medical versus surgical treatment of renovascular hypertension . In: Stanley JC, Ernst CB, Fry WJ, eds. Renovascular Hypertension . Philadelphia, Pa: WB Saunders Co; 1984:354-362. 17. Pickering TG, Sos TA. Medical aspects of renal angioplasty . In: Glorioso N, Laragh JH, Rappelli A, et al, eds. Renovascular Hypertension . New York, NY: Raven Press; 1987:413-424. 18. Hollenberg NK. Renal hemodynamics in essential and renovascular hypertension: influence of captopril . Am J Med . 1984;76:22-28.Crossref 19. Hall JE, Guyton AC, Jackson TE, Coleman TG, LohmeierTE, Trippodo NC. Control of glomerular filtration rate by renin-angiotensin system . Am J Physiol. 1977;233:F366-F372. 20. Huang WC, Ploth DW, Bell PD, Work J, Navar LG. Bilateral renal function responses to converting enzyme inhibitor (SQ 20,881) in two-kidney, one clip Goldblatt hypertensive rats . Hypertension . 1981;3:285-293.Crossref 21. Textor SC, Novick A, Mujais SK, et al. Responses of the stenosed and contralateral kidneys to (Sar1, Thr8) All in human renovascular hypertension . Hypertension . 1983;5:796-804.Crossref 22. Miyamori I, Yasuhara S, Takeda Y, et al. Effects of converting enzyme inhibition on split renal function in renovascular hypertension . Hypertension . 1986;8:415-421.Crossref 23. Vaughan ED Jr. Renovascular hypertension . Kidney Int. 1985;27:811-827.Crossref 24. Dean RH, Kieffer RW, Smith BM, et al. Renovascular hypertension: anatomic and renal function changes during drug therapy . Arch Surg . 1981;116:1408-1415.Crossref 25. Weinberger MH, Grim CE, Luft FC, Yune HY. Percutaneous transluminal angioplasty in complicated renal vascular hypertension . Nephron . 1986; 44( (suppl 1) ):51-53.Crossref 26. Ying CY, Tifft CP, Gavras H, Chobanian AV. Renal revascularization in the azotemic hypertensive patient resistant to therapy . N Engl J Med . 1984;311:1070-1075.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

Captopril Therapy Following Percutaneous Transluminal Angioplasty for Bilateral Renal Artery Stenosis

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References (26)

Publisher
American Medical Association
Copyright
Copyright © 1989 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1989.00390090047010
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Abstract

Abstract • To establish an optimal approach for the patients with bilateral atherosclerotic renal artery stenosis, combined treatment involving percutaneous transluminal renal angioplasty and oral captopril was applied. Five patients were examined for effects of the combined treatment on blood pressure and renal function. After percutaneous transluminal renal angioplasty on one renal artery, the blood pressure (mean ± SD) fell from 210/118 26/8 to 176/104 11/9mm Hg without any deterioration of renal function. This reduced blood pressure was further lowered to 155/92 ± 6/3 mm Hg by adding captopril therapy. This level of blood pressure has been maintained for an average of 37 months. Significant increases in serum creatinine concentration were not observed (124 27 vs 141 44 μmol/L), and renal size has been sustained. These results indicate that combined treatment with percutaneous transluminal renal angioplasty and captopril is effective in reducing the blood pressure and preserving renal function as an approach for the patients with bilateral atherosclerotic renal artery stenosis. (Arch Intern Med. 1989;149:1973-1976) References 1. Aldigier JC, Plouin PF, Guyene TT, Thibonnier M, Corvol P, Menard J. Comparison of the hormonal and renal effects of captopril in severe essential andrenovascularhypertension . Am J Cardiol . 1982;49:1447-1452.Crossref 2. Reams GP, Bauer JH, Gaddy P. Use of the converting enzyme inhibitor enalapril in renovascular hypertension: effect on blood pressure, renal function, and the renin-angiotensin-aldosterone system . Hypertension . 1986;8:290-297.Crossref 3. Dean RH, Oates JA, Wilson JP, et al. Bilateral renal artery stenosis and renovascular hypertension . Surgery . 1977;81:53-62. 4. Lawrie GM, Morris GC Jr, Soussou ID, et al. Late results of reconstructive surgery for renovascular disease . Ann Surg . 1980;191:528-533.Crossref 5. Sos TA, Pickering TG, Sniderman K, et al. Percutaneous transluminal renal angioplasty in renovascular hypertension due to atheroma or fibromusculardysplasia . N Engl J Med . 1983;309:274-279.Crossref 6. Geyskes GG, Puylaert CBAJ, Oei HY, Mees EJD. Follow-up study of 70 patients with renal artery stenosis treated by percutaneous transluminal dilatation . Br Med J. 1983;287:333-336.Crossref 7. Tegtmeyer CJ, Kellum CD, Ayers C. Percutaneous transluminal angioplasty of the renal artery: results and long-term follow-up . Radiology . 1984;153:77-84.Crossref 8. Kuhlmann U, Greminger P, Gruentzig A, et al. Long-term experience in percutaneous transluminal dilatation of renal artery stenosis . Am J Med . 1985;79:692-698.Crossref 9. Schreiber MJ, Pohl MA, Novick AC. The natural history of atherosclerotic and fibrous renal artery disease . Urol Clin North Am . 1984;11:383-392. 10. Chrysant SG, Dunn M, Marples D, DeMasters K. Severe reversible azotemia from captopril therapy: report of three cases and review of the literature . Arch Intern Med . 1983;143:437-441.Crossref 11. Hricik DE, Browning PJ, Kopelman R, Goorno WE, Madias NE, Dzau VJ. Captopril-induced functional renal insufficiency in patients with bilateral renal-artery stenoses or renal-artery stenosis in a solitary kidney . N Engl J Med . 1983;308:373-376.Crossref 12. Hoorntje SJ, Donker AJM, Schuur KH, Boomsma JHB. Renal artery dilatation in a patient on captopril: changing a 'two-kidney, two-clip hypertension' into a 'two-kidney, one-clip hypertension.' Nephron . 1982;30:56-59.Crossref 13. Narimatsu Y, Tanimoto A, Kohda E, Hisa N, Iwata Y, Hiramatsu K. Percutaneous transluminal angioplasty in renovascular hypertension: long-term follow-up . Nippon Acta Radiol . 1986;46:585-594. 14. Maxwell MH, Bleifer KH, Franklin SS, Varady PD, Deegan C. Cooperative study of renovascular hypertension: demographic analysis of the study . JAMA . 1972;220:1195-1204.Crossref 15. Swinton NW Jr, Breslin DJ, Libertino JA, Zinman L. Renovascular hypertension: therapeutic decisions and results . In: Breslin DJ, Swinton NW Jr, Libertino JA, Zinman L, eds. Renovascular Hypertension . Baltimore, Md: Williams & Wilkins; 1982:213-221. 16. Dean RH, Hollifield JW, Oates JA. Medical versus surgical treatment of renovascular hypertension . In: Stanley JC, Ernst CB, Fry WJ, eds. Renovascular Hypertension . Philadelphia, Pa: WB Saunders Co; 1984:354-362. 17. Pickering TG, Sos TA. Medical aspects of renal angioplasty . In: Glorioso N, Laragh JH, Rappelli A, et al, eds. Renovascular Hypertension . New York, NY: Raven Press; 1987:413-424. 18. Hollenberg NK. Renal hemodynamics in essential and renovascular hypertension: influence of captopril . Am J Med . 1984;76:22-28.Crossref 19. Hall JE, Guyton AC, Jackson TE, Coleman TG, LohmeierTE, Trippodo NC. Control of glomerular filtration rate by renin-angiotensin system . Am J Physiol. 1977;233:F366-F372. 20. Huang WC, Ploth DW, Bell PD, Work J, Navar LG. Bilateral renal function responses to converting enzyme inhibitor (SQ 20,881) in two-kidney, one clip Goldblatt hypertensive rats . Hypertension . 1981;3:285-293.Crossref 21. Textor SC, Novick A, Mujais SK, et al. Responses of the stenosed and contralateral kidneys to (Sar1, Thr8) All in human renovascular hypertension . Hypertension . 1983;5:796-804.Crossref 22. Miyamori I, Yasuhara S, Takeda Y, et al. Effects of converting enzyme inhibition on split renal function in renovascular hypertension . Hypertension . 1986;8:415-421.Crossref 23. Vaughan ED Jr. Renovascular hypertension . Kidney Int. 1985;27:811-827.Crossref 24. Dean RH, Kieffer RW, Smith BM, et al. Renovascular hypertension: anatomic and renal function changes during drug therapy . Arch Surg . 1981;116:1408-1415.Crossref 25. Weinberger MH, Grim CE, Luft FC, Yune HY. Percutaneous transluminal angioplasty in complicated renal vascular hypertension . Nephron . 1986; 44( (suppl 1) ):51-53.Crossref 26. Ying CY, Tifft CP, Gavras H, Chobanian AV. Renal revascularization in the azotemic hypertensive patient resistant to therapy . N Engl J Med . 1984;311:1070-1075.Crossref

Journal

Archives of Internal Medicine – American Medical Association

Published: Sep 1, 1989

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