신동맥 결찰술 후 발생한 신증후군 범위의 단백뇨를 동반한 신혈관성 고혈압: ACE 억제제와 안지오텐신 II 1형 수용체 차단제 병합요법에 의한 성공적 치료

Abstract

A 27-year-old woman presented with severe hypertension and nephrotic range proteinuria. She had a blunt renal trauma 4 weeks ago and was treated by the left main renal artery ligation. The plasma renin activity, angiotension II and aldosterone levels were very high and the abdominal angiography showed the occlusion of the left main renal artery with relatively preserved blood flow in upper pole of the left kidney. In captopril renal scan, relatively preserved perfusion in upper pole of left kidney was further compromised after captopril administration. The massive proteinuria and hypertension were improved after combination of ACE inhibitor and angiotensin II type 1 receptor blocker treatment.