PEDIATRICS Vol. 88 No. 4 October 1991, pp. 816-818
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Captopril-Induced Reversible Acute Renal Failure in an Infant With Coarctation of the Aorta

ELLEN G. WOOD MD1, TIMOTHY E. BUNCHMAN MD1, and ROBERT E. LYNCH MD, PHD1

1 Department of Pediatrics, St. Louis University School of Medicine

Activation of the renin-angiotensin system has been implicated in the initiation of hypertension associated with coarctation of the aorta, with sodium and volume expansion playing a role in maintenance of the hypertension. Increase in total peripheral resistance induced by the stenosis itself also has received increasing attention in the etiology of coarctation and renal vascular hypertension.1-5 To date, angiotensin-converting enzyme (ACE) inhibitors have been used to lower acutely blood pressure in patients with coarctation, as well as in "paradoxical" postoperative treatment of hypertension.2,6 We recently cared for a small infant with hypertension due to coarctation of the aorta who developed acute renal insufficiency while receiving captopril.

Submitted on October 22, 1990
Accepted on December 5, 1990