Reversible nephrotic range proteinuria and renal failure in atheroembolic renal disease

A case is described in which atheroembolic renal disease was associated with nephrotic range proteinuria, sub-acute renal failure, severe hypertension and microhematuria, in the absence of typical peripheral stigmata of atheroemboli. Nephrotic range proteinuria has not been previously reported in atheroembolic renal disease. With sustained aggressive treatment of hypertension there was diminution and eventual clearing of the proteinuria accompanied by marked improvement in renal function. The histopathology, the indications for renal biopsy, and possible causes of proteinuria are discussed.