Captopril-Induced Functional Renal Insufficiency in Patients with Bilateral Renal-Artery Stenoses or Renal-Artery Stenosis in a Solitary Kidney

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Abstract
ACUTE renal failure occasionally complicates therapy with the oral angiotensin-converting-enzyme inhibitor captopril.1 2 3 4 5 A variety of mechanisms have been postulated to account for captopril-induced renal insufficiency, including direct drug nephrotoxicity,1 hypersensitivity,2 and renal ischemia due to rapid reductions in systemic blood pressure.3 However, the clinical importance of these complications and the types of patients at risk have not been defined.We describe 11 patients in whom acute renal insufficiency developed while they were receiving captopril for treatment of severe hypertension associated with either bilateral renal-artery stenosis or renal-artery stenosis in a solitary kidney. In each case, the renal insufficiency resolved promptly . . .