- 作者：Alain Wynckel ; Bertin Ebikili ; Jean-Pierre Melin ; Christine R ; oux ; Sylvie Lavaud ; Jacques Chanard
- 刊名：American Journal of Hypertension
- 出版年：1998
- 出版时间：September 1998
- 年：1998
- 卷：11
- 期：9
- 页码：1080-1086
- 全文大小：151 K
Sixty-four patients who were admitted to the intensive care unit for ARF associated with ACE inhibitor therapy were followed for more than 5 years. In this historical retrospective study, we documented that 45 patients were treated for hypertension (group I) and 19 were treated for heart failure (group II). Their mean age was 71.2 ± 11.6 years. Patients with ARF presented with overt dehydration in 91 % and 84 % of the cases in groups I and II, respectively. Hypovolemia was caused by diuretics or gastrointestinal fluid loss. Bilateral artery-renal stenosis or stenosis in a solitary kidney was documented in 22 % and 10 % of patients in groups I and II, respectively. The probability of survival was 91 % and 49 % at 1 year and 64 % and 18 % at 5 years, for groups I and II, respectively. Acute renal failure required hemodialysis in seven patients, but none of them became dialysis dependent. In the subgroup of patients with preexisting chronic renal failure, all the patients except for one who belonged to group II died within 2 years. In both groups, after resolution of ARF, plasma creatinine concentration returned to baseline level and the course of renal function was not significantly worsened.
In conclusion, ARF associated with ACE inhibitors is likely to occur in many patients without renal artery stenosis after unexpected dehydration, especially in older patients with congestive heart failure. In both groups of patients, in the absence of preexisting chronic uremia, recovery of renal function occurred without sequelae, even after an episode of acute tubular necrosis requiring dialysis.