The causal role of salt depletion in acute renal failure due to captopril in hypertensive patients with a single functioning kidney and renal artery stenosis

Vittorio E. Andreucci, Giuseppe Conte, Antonio Dal Canton, Giovanni Di Minno, Mario Usberti

Research output: Contribution to journalArticle

Abstract

Captopril (C) causes ARF in hypertensive patients with renal artery stenosis (RAS) with a single functioning kidney (SK). Retrospective studies in two patients showed that episodes of C-induced ARF were preceded by a rise in urinary Na+ excretion and a rapid decrease in body weight. These observations prompted us to investigate whether extracellular fluid volume depletion secondary to C-induced natriuresis can be responsible for ARF. Prospective studies were performed in four patients with RAS-SK treated with C. These studies have shown that: (a) ARF is associated with negative Na+ balance and is corrected by salt replacement, even without interrupting C; (b) ARF is preceded by a rise in urinary prostaglandin (PG) E2 and 6-keto-F; (c) ARF is prevented by either saline infusion or aspirin administration; (d) ARF does not occur when the dose of C is not sufficient to raise PGs and urinary Na+ excretion. We conclude therefore that C-induced ARF in patients with RAS-SK can be secondary to salt depletion dependent on a raised secretion of PGs.

Original languageEnglish
Pages (from-to)9-20
Number of pages12
JournalRenal Failure
Volume10
Issue number1
DOIs
Publication statusPublished - 1987

ASJC Scopus subject areas

  • Nephrology
  • Critical Care and Intensive Care Medicine

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