[TREATMENT OF SEVERE ATHEROSCLEROTIC RENAL ARTERY STENOSIS WITH ACUTE KIDNEY INJURY REQUIRING HEMODIALYSIS BY PERCUTANEOUS TRANSLUMINAL RENAL ANGIOPLASTY AND STENT IMPLANTATION].

Treatment of atherosclerotic renal artery stenosis (RAS) is still controversial. Several randomized controlled trials have shown that percutaneous transluminal renal angioplasty with stenting (PTRAS) is not superior to medical treatment, and the procedure is commonly reserved for malignant hypertension, flash pulmonary edema or deterioration of kidney function. The most challenging symptomatic RAS cases are patients with severe stenosis resulting in acute kidney injury (AKI) requiring acute hemodialysis. The risk-benefit ratio in these cases is uncertain. While those patients might benefit the most from revascularization, the success rate after prolonged time on dialysis is unknown. This is a representative case study of a patient with solitary kidney and high grade RAS who presented with anuric AKI indicated for hemodialysis. Twenty-eight days after starting hemodialysis the patient underwent PTRAS as a rescue therapy and 5 days after the procedure urine output resumed, the patient became polyuric and kidney function improved and the patient stopped hemodialysis.