Reversible renin mediated massive proteinuria successfully treated by nephrectomy.

We report on a patient with severe hypertension and nephrotic range proteinuria, which were renin mediated in origin. Aortography demonstrated occlusion of the right renal artery and renal vein renin measurements lateralized strongly to the right kidney. Removal of the right kidney led to amelioration of hypertension and proteinuria. Massive proteinuria in this setting is due to high levels of intrarenal angiotensin II and is reversible with deactivation of the renin-angiotensin system.