A case of renal failure due to primary cholesterol atheroembolism

Mitsunobu Matsubara, Yoshio Taguma, Osamu Hotta, Kousei Kurosawa, Katsuhiro Nakamura, Kuniaki Matsui

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1 Citation (Scopus)


We report a patient presenting rapid deterioration of renal function due to primary cholesterol atheroembolism. The patient was 75-year-old hypertensive male and was admitted to a hospital because of rt. hemiplegia which developed 2 weeks earlier. On admission, his blood pressure was 200/100 mmHg and serum creatinine level was 2.9 mg/ dl with urinalysis 1+ both for protein and hematuria. 2 weeks later, an angiotensin converting enzyme inhibitor (ACE inhibitor, delapril 15 mg/day) was given to control high blood pressure. Immediately after this medication, his renal failure rapidly progressed with a fall in blood pressure (110/60 mmHg) and oliguria (100 ml/day). Although he was transferred to our hospital and was treated with hemodialysis, he died of an attack of acute myocardial infarction in a week. At post-mortem examination, microscopic findings of the kidney disclosed numerous occlusions of medium-sized artery by cholesterol emboli. These emboli were also observed in other organs, but not so prominent as in the kidney. The coronary arteries exhibited severe sclerosis. In this presented case, acute deterioration of renal function was caused by ACE-inhibitor, although which was administered in a volume depleted condition. Therefore, further study would be necessary whether or not ACE-inhibitors predispose the patients with this disease to acute renal failure.

Original languageEnglish
Pages (from-to)417-421
Number of pages5
JournalThe Japanese Journal Of Nephrology
Issue number4
Publication statusPublished - 1991 Jan
Externally publishedYes


  • angiotensin converting enzyme inhibitor
  • primary cholesterol atheroembolism
  • renal failure

ASJC Scopus subject areas

  • Nephrology


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