HDCN Article Review/Hyperlink

Saine DR, Ahrens ER

Renal impairment associated with losartan

Ann Int Med (Apr) 124:775 1996

Saine and Ahrens report a diabetic woman who developed oliguric renal failure six weeks after starting the angiotensin II receptor antagonist Losartan for hypertension. The patient had a past history of Type II diabetes mellitus, diffuse atherosclerotic vascular disease and a small right kidney. Renal function returned to baseline levels after the drug was discontinued.

Comment: This case is the first report of oliguric acute renal failure following treatment with Losartan. Pharmacological interruption of the renin-angiotensin system by converting enzyme inhibitors is well know to cause hemodynamic deterioration of glomerular filtration in patients with ineffective circulating fluid volume to the kidneys. These patients include those with congestive heart failure, intravascular volume contraction, bilateral renal artery stenosis, and diffuse microvascular disease. Because Losartan has a similar functional effect on the renin-angiotensin system through direct receptor blockade, it should be expected to cause similar renal hemodynamic effects, including sudden decrease of glomerular filtration. (George R. Aronoff, M.D., University of Louisville, Kentucky)