肾血管成形术与血管紧张素转换酶抑制剂联合应用可降低双侧肾动脉疾病患者的蛋白尿。
Combination of Renal Angioplasty and Angiotensin-converting-enzyme Inhibitor Can Reduce Proteinuria in Patients with Bilateral Renal Artery Disease.
作者信息
Toda Hironobu, Uchida Haruhito, Nakamura Kazufumi, Takeuchi Hidemi, Kinomura Masaru, Nakagawa Koji, Watanabe Atsuyuki, Miyoshi Toru, Nishii Nobuhiro, Morita Hiroshi, Wada Jun, Ito Hiroshi
机构信息
Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan.
Department of Nephrology, Rheumatology, Endocrinology and Metabolism, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan.
出版信息
Intern Med. 2019 Jul 1;58(13):1917-1922. doi: 10.2169/internalmedicine.2076-18. Epub 2019 Feb 25.
Recent large clinical trials failed to show clear benefits of percutaneous transluminal renal angioplasty (PTRA) as compared with medical therapy on patients with renal artery stenosis. It was also reported that proteinuria is an adverse prognostic factor after PTRA, and PTRA is less effective in patients with overt proteinuria. From the renoprotective point of view, to reduce proteinuria after PTRA is an important therapeutic goal in patients with renal artery stenosis with overt proteinuria. We hereby describe two patients successfully treated by combination therapy with PTRA and administration of angiotensin-converting enzyme (ACE) inhibitor for bilateral renal artery disease with overt proteinuria.
近期的大型临床试验未能表明，经皮腔内肾血管成形术（PTRA）相较于药物治疗，对肾动脉狭窄患者有明显益处。也有报道称，蛋白尿是PTRA术后的不良预后因素，且PTRA对明显蛋白尿患者的疗效较差。从肾脏保护的角度来看，减少PTRA术后的蛋白尿是有明显蛋白尿的肾动脉狭窄患者的重要治疗目标。我们在此描述两名双侧肾动脉疾病伴明显蛋白尿患者，通过PTRA与血管紧张素转换酶（ACE）抑制剂联合治疗获得成功。
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