Abstract
Takayasu's Arteritis Renal Involvement is usually characterized by renovascular hypertension and reduction in glomerular filtration rate (GFR) has rarely been described. A twelve year old boy presented with severe hypertension (diastolic BP> 120mmHg) and oligoanuria. Aortography demonstrated irregular narrowing of the lumbar aorta and renal arteries. Chronic renal insufficiency (GFR< 2ml/min/1.73M2) necessitated maintenance hemodialysis. During this time severe hypertension persisted despite aggressive dialysis and numerous antihypertensive drugs. Plasma renin activity was persistently 15 > ng/ml/hr. Follow-up arteriograms showed no improvement in his arteritis. Renal scans demonstrated persistent poor perfusion. Renal biopsy after eight months of dialysis showed preservation of glomerular architecture with mild arteriolar intimal thickening. After 9 months on dialysis GFR improved spontaneously to 32ml/min/1.73M2 despite no improvement in his hypertension. Off dialysis, he remains severely hypertensive, with stable GFR. This report emphasises the remarkable ability of the renal parenchyma to recover function after sustained ischemia.
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Weiss, R., Jodorkovsky, R., Greifer, I. et al. 1553 CHRONIC RENAL FAILURE DUE TO TAKAYASU'S DISEASE: RECOVERY OF RENAL FUNCTION AFTER NINE MONTHS OF DIALYSIS. Pediatr Res 15 (Suppl 4), 702 (1981). https://doi.org/10.1203/00006450-198104001-01570
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DOI: https://doi.org/10.1203/00006450-198104001-01570
