End-stage renal failure after irbesartan prescription in a diabetic patient with previously stable chronic renal insufficiency

We report the case of a 78-year-old hypertensive diabetic patient without e vidence of renal artery stenosis who had moderate chronic renal insufficien cy, which had been stable for several years under low-dose captopril therap y, and who rapidly developed acute renal failure when irbesartan was prescr ibed. Unfortunately the medication was not stopped promptly and the patient never recovered his basal renal function and had to undergo chronic hemodi alysis. This observation emphasizes the importance of a careful monitoring of renal function in patients receiving angiotensin II receptor antagonists .