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Table 1 Clinical manifestations in three patients with FSGS after renal angioplasty

From: A case report of successfully treated nephrotic syndrome after renal angioplasty

 

Kanagasundaram et al. [11]

Almirall et al. [12]

This patient

Age (years)

65

72

48

Sex

Female

Male

Male

Blood pressure (mmHg)

220/120

240/120

160/90

Anti-HTN drugs

Amlodipine, doxazocin, furosemide

Amlodipine, lisinopril, hydrochlorothiazide

Carvedilol, hydrochlorothiazide

Serum creatinine (mg/dl)

2.07

1.90

1.42

Proteinuria before angioplasty

Normal

100 mg/day

0.4 g/g

Renal angiography

 Degree of RAS (%)

95

80

80

 Opposite kidney

Non-perfused

Complete occlusion

Non-functional

Onset of nephrotic syndrome after angioplasty (weeks)

2

3

4

Proteinuria after angioplasty

5.9 g/day

13 g/day

11.6 g/g

PRA before angioplasty

19.32 ng/ml/hr

PRA after angioplasty (reference)

11.6 pmol/ml/hr. (2.8–4.5)

669 pg/ml (< 300)

60.6 mg/ml/hr. (1.31–3.95)

Management

ACEI

 

ARB

Change in proteinuria

3.1 g/day (2 weeks with ACEI)

16 g/day

2.2 g/g (9 weeks with ARB)

Follow-up

Proteinuria 6.5 g/day (after ACEI withdrawal)

Death due to ICH at 4 months after angioplasty

uPCR 0.4 g/g (1 year with ARB)

  1. Abbreviations: ACEI angiotensin-converting enzyme inhibitor, ARB angiotensin receptor blocker, HTN hypertension, ICH intracranial hemorrhage, PRA plasma renin activity, RAS renal artery stenosis, uPCR urine protein-to-creatinine ratio