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[A 'lucky' patient]
T Lusenti1, R Rustichelli, F Cardarelli
1U.O. di Nefrologia e Dialisi, Azienda Ospedaliera S. Maria Nuova, Reggio Emilia - Italy. lusenti.tiziano@asmn.re.it
Summary
A diabetic patient with rapidly progressive renal failure and severe right renal artery stenosis improved significantly after stenting. The patient was successfully weaned off hemodialysis, demonstrating the effectiveness of renal artery stenting in select cases.
Area of Science:
- Nephrology
- Vascular Medicine
- Interventional Cardiology
Background:
- A 72-year-old male with diabetes mellitus presented with rapidly progressive renal failure.
- The patient exhibited hypertension, nephrotic proteinuria, and microhematuria, necessitating hemodialysis.
- Diagnostic workup revealed severe stenosis of the right renal artery and a hypoplastic left kidney.
Observation:
- The patient underwent hemodialytic treatment for end-stage renal disease.
- Renal angiography confirmed significant atherosclerotic stenosis in the right renal artery.
- The clinical presentation suggested renovascular hypertension as a contributing factor to renal decline.
Findings:
- Successful stenting of the right renal artery was performed.
- Post-procedure, a significant reduction in serum creatinine levels was observed.
- The patient was successfully weaned off hemodialytic treatment, indicating improved renal function.
Implications:
- Renal artery stenting can be a viable treatment option for select patients with renovascular hypertension and progressive renal failure.
- Intervention may halt or reverse renal function decline, potentially avoiding the need for long-term dialysis.
- This case highlights the importance of evaluating for renal artery stenosis in diabetic patients with unexplained renal failure and hypertension.