Renal artery thrombosis with acute renal failure after withdrawal of angiotensin converting enzyme inhibitor: a case report.

Sir, Acute renal failure is a well known complication after treatment with angiotensin converting enzyme inhibitors (ACEIs) or angiotensin II antagonists w1,2x and usually resolves after rehydration and withdrawal of diuretics. Thrombosis of the renal arteries in association with acute renal failure during ACEI therapy is unusual and may be causally related to severe hypotension w3,4x. We report a case where an initial and reversible ACEI-induced acute renal failure was succeeded by another episode of acute renal failure due to bilateral renal artery occlusion and renal artery thrombosis after the withdrawal of ACEI.