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The Ewha Medical Journal
Ewha Womans University School of Medicine

Ewha Med J 2010; 33(1):29-33

pISSN: 1598-7450

DOI: https://doi.org/10.12771/emj.2010.33.1.29

Case Report

Acute Renal Failure with Pulmonary Edema Induced by the Treatment of Angiotensin-Converting Enzyme Inhibitor and Angiotensin II Receptor Blocker in a Patient with Congenital Solitary Kidney

Doo Hyun Baek, Kyung Jin Kim, Sung Chul Hong, Suk Hyung Kang, Ha Eung Song, Hye In Kim, Soo Hyun Kim, Hyun Jung Oh, Hye Won Kang, Seo Woo Kim, Min-A Yu, Dong-Ryeol Ryu, Kyu-Bok Choi, Duk-Hee Kang
Corresponding author (dhkang@ewha.ac.kr)

Copyright ⓒ 2010. Ewha Womans University School of Medicine. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Published Online: Mar 31, 2010

Abstract

Blockers of renin-angiotensin system(RAS) including ACE inhibitor or ARB are one of the most frequently prescribed medications for the treatment of hypertension, heart failure and proteinuria. One of the major side effects of these RAS blockers is the deterioration of renal function, mainly due to a reduction of intraglomerular pressure. Therefore, close monitoring of renal function is recommended when RAS blockers are initially prescribed, especially for the patients with impaired renal function.

We report a patient who was transferred to our hospital due to the sudden development of oliguria and dyspnea after treatment for hypertension with ACEi and ARB. She was finally diagnosed as RAS blocker-induced acute renal failure with pulmonary edema complicated on congenital solitary kidney. After hemodialysis and conservative treatment, her renal function was recovered with maintenance of normal urine output.

Conclusion

This case highlights the necessity of the functional and structural evaluation of kidney to prevent the serious complication such as acute renal failure before the administration of ACEi and/or ARB.

Keywords: Acute kidney failure; pulmonary edema; Angiotensin-converting enzyme Inhibitors; Angiotensin II Type 1 receptor blockers; Congenital solitary kidney