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  • Title: [Renal insufficiency after administration of captopril in renal artery stenosis with a single kidney or bilateral stenosis is not compulsory].
    Author: Durand D, Tran Van T, Ader JL, Suc JM.
    Journal: Arch Mal Coeur Vaiss; 1984 Oct; 77(11):1272-7. PubMed ID: 6441547.
    Abstract:
    Acute renal failure has been reported during captopril therapy of hypertension due to renal artery stenosis with a single kidney or bilateral renal artery stenosis. Under low perfusion pressures inhibition of the renin-angiotensin system could disturb the autoregulation, decrease efferent arteriolar resistance and lead to a critical decrease in glomerular filtration. Renal function tests were repeated in a patient with hypertension due to 90 p. 100 renal artery stenosis with a single kidney, before and after captopril administration (sodium intake 100 mmol/24 h). (table; see text) Identical results have also been observed in a patient with bilateral renal artery stenosis. Both patients presented high risk renal haemodynamic states. The control of systemic blood pressure and the fall in filtration fraction were not associated with a critical, immediate or short term fall in glomerular filtration. The isolated administration of captopril is therefore not systematically contra-indicated in these two clinical situations.
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