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BMC Nephrology
Published in: BMC Nephrology 1/2012

Open Access 01-12-2012 | Case report

Juxtaglomerular apparatus hyperplasia under dual angiotensin blockade. A footprint of adequate RAS inhibition or a concern for renal fibrosis?

Authors: Beatriz Fernandez-Fernandez, Alberto Ortiz, Carmen Gomez-Guerrero, Antonio Barat, Catalina Martín-Cleary, Jesús Egido

Published in: BMC Nephrology | Issue 1/2012

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Abstract

Background

Dual renin-angiotensin system blockade with angiotensin-converting enzyme inhibitors and angiotensin receptor blockers has been advocated to minimize proteinuria. However, recent trials have questioned the renal safety of this approach. Our understanding on the molecular effects of dual blockade in humans is incomplete.

Case presentation

We present a patient with corticoid resistant nephrotic syndrome who developed marked juxtaglomerular apparatus hyperplasia and renin expression in the context of dual angiotensin system blockade.

Conclusions

Although renin may have profibrotic effects mediated by (pro)renin receptor activation, this report raises questions on the potential consequences of local renin activation on chronic kidney disease in patients with dual angiotensin blockade.
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Metadata
Title
Juxtaglomerular apparatus hyperplasia under dual angiotensin blockade. A footprint of adequate RAS inhibition or a concern for renal fibrosis?
Authors
Beatriz Fernandez-Fernandez
Alberto Ortiz
Carmen Gomez-Guerrero
Antonio Barat
Catalina Martín-Cleary
Jesús Egido
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Nephrology / Issue 1/2012
Electronic ISSN: 1471-2369
DOI
https://doi.org/10.1186/1471-2369-13-21

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