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首页> 美国卫生研究院文献>CEN Case Reports >Successful long-term effects of direct renin inhibitor aliskiren in a patient with atherosclerotic renovascular hypertension
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Successful long-term effects of direct renin inhibitor aliskiren in a patient with atherosclerotic renovascular hypertension

机译：直接肾素抑制剂阿利吉仑对动脉粥样硬化性肾血管性高血压患者的成功长期疗效

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A 64-year-old man visited our hospital with complaints of misty vision and ophthalmalgia. On admission, his blood pressure (BP) was high at 220/135 mmHg with no past history of hypertension, and he had choked discs. He was tentatively diagnosed as having idiopathic intracranial hypertension, and was later found to have atherosclerotic unilateral renovascular hypertension (RVH) based upon the extremely high plasma renin activity together with the radiological image tests. On day 3, combined antihypertensive therapies consisting of oral angiotensin II receptor blocker (ARB) and Ca channel blocker (CCB) along with intravenous CCB induced an abrupt BP lowering which led to deterioration of his renal function, progressing into acute kidney injury (AKI). Cessation of the ARB and reduction of the CCB dose ameliorated the AKI-related decline in renal function. On day 17, as he was reluctant to receive surgical intervention, he was treated with a direct renin inhibitor, aliskiren, combined with a half-dose CCB as a maintenance antihypertensive therapy. The therapy has proven not only successful to chronically maintain his renal function but was also capable of controlling his BP in the neighborhood of 130/85 mmHg over a period of 2 years. The present case suggests that the direct renin inhibition with aliskiren can be a safe and useful antihypertensive option to control hypertension and to preserve renal function in patients with atherosclerotic unilateral RVH.
机译：一名64岁的男子因视力不佳和眼痛而来我院就诊。入院时，他的血压（BP）高达220/135 mmHg，无高血压史，并且有椎间盘cho住。初步诊断他患有特发性颅内高压，后来由于血浆肾素活性极高以及放射影像学检查发现他患有动脉粥样硬化性单侧肾血管性高血压（RVH）。在第3天，由口服血管紧张素II受体阻滞剂（ARB）和钙通道阻滞剂（CCB）以及静脉内CCB组成的联合降压疗法引起了BP突然降低，导致其肾功能恶化，并发展为急性肾损伤（AKI） 。停止ARB和减少CCB剂量可改善AKI相关的肾功能下降。在第17天，由于他不愿接受外科手术，他接受了直接的肾素抑制剂阿利吉仑治疗，并结合半剂量CCB作为维持性降压治疗。事实证明，该疗法不仅可以成功地长期维持其肾功能，而且还能够在2年的时间内将其血压控制在130/85 mmHg附近。目前的情况表明，用阿利吉仑直接抑制肾素可以是控制动脉粥样硬化单侧RVH患者控制高血压和保持肾功能的安全和有用的降压选择。

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