Jegatheswaran Januvi, Hadziomerovic Adnan, Ruzicka Marcel
Division of Nephrology, Department of Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada.
Department of Radiology, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada.
Can J Cardiol. 2021 Oct;37(10):1671-1673. doi: 10.1016/j.cjca.2021.04.008. Epub 2021 Apr 20.
We present a case of severe renal artery stenosis that mimicked rapidly progressive glomerulonephritis with acute kidney injury, active urine sediments, and severe hypertension. Simultaneous presence of secondary hyperaldosteronism and hypokalemia prompted renal angiography and subsequent renal artery angioplasty and stenting, leading to rapid resolution of acute kidney injury, proteinuria, and hypertension. This case emphasises the importance and benefits of prompt diagnosis and revascularisation of acute severe renal artery stenosis in a patient with history of atherosclerotic renovascular disease presenting with sudden onset of severe hypertension and acute kidney injury with active urine sediment mimicking rapidly progressive glomerulonephritis.
我们报告一例严重肾动脉狭窄病例，该病例表现为类似急进性肾小球肾炎，伴有急性肾损伤、活动性尿沉渣及严重高血压。继发性醛固酮增多症和低钾血症同时存在促使进行肾血管造影，随后进行肾动脉血管成形术和支架置入术，从而使急性肾损伤、蛋白尿和高血压迅速得到缓解。该病例强调了对于有动脉粥样硬化性肾血管疾病病史、突发严重高血压及伴有活动性尿沉渣的急性肾损伤（类似急进性肾小球肾炎）的患者，及时诊断并对急性严重肾动脉狭窄进行血运重建的重要性和益处。
