[Acute reversible kidney insufficiency due to enalapril during diuretic-treated heart insufficiency]

Acute reversible renal failure with hyperkalemia developed in a 42-year-old woman during treatment of heart failure and hypertension with high doses of enalapril and diuretics. Creatinine clearance fell as low as 9 ml/min. Renal-artery stenosis and prerenal renal failure were excluded. Reduction in blood pressure in conjunction with reduced renal perfusion in heart failure can make glomerular filtration angiotensin dependent. Interruption of angiotensin II formation in this situation triggers off functional renal insufficiency.