ACUTE-RENAL-FAILURE INDUCED BY ANGIOTENSIN-CONVERTING ENZYME-INHIBITOR IN A PATIENT WITH POLYARTERITIS-NODOSA

We report a patient who presented with malignant hypertension and rena l failure. He was treated with lisinopril, spironolactone, and nifedip ine retard for blood pressure control. Subsequent renal function showe d further deterioration, bur it then improved after withdrawal of the angiotensin converting enzyme inhibitor (ACE I). The diagnosis of clas sical polyarteritis nodosa was established with aneurysmal dilatation demonstrable in the renal vasculature. His renal impairment improved f urther following immunosuppressive therapy and the disease has remaine d inactive 4 years after first presentation. This is the first reporte d case of acute renal failure associated with the use of ACE I in poly arteritis nodosa.