Expression of 90-kDa heat shock protein within regenerative tubular cells in a patient with acute oliguric renal failure due to malignant hypertension

A 29-year-old man developed acute oliguric renal failure with severe hypert ension and microangiopathy. He was treated with hemodialysis and anti-hyper tensive drugs, but oliguria was prolonged. A renal biopsy was performed on the 29th hospital day. Small arteries and arterioles were characterized by marked intimal thickening, and most of the glomeruli showed ischemic change s. Although there was extensive tubular loss and atrophy regenerative chang es were occasionally observed in some tubules, in which 90-kDa heat-shock p rotein was induced. He was diagnosed as having malignant nephrosclerosis an d was treated with a prostaglandin I-2 analog, in addition to anti-hyperten sive drugs. Thereafter, his renal function recovered gradually, and hemodia lysis was discontinued on the 49th hospital day. Functional recovery lasts more than five years. We suggest that the expression of HSP90 in regenerati ve tubular cells is a useful histological indicator for predicting recovery from acute oliguric renal failure due to malignant hypertension.