IMephrotic-Range Proteinuria in a Patient with High Renin Hypertension: Effect of Treatment with an ACE-lnhibitor

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Abstract
A 65-year-old man presented proteinuria in the nephrotic range that occurs in the setting ofhigh renin hypertension. Proteinuria persisted after normalizing blood pressure by nifedipine. In contrast, treatment with an ACE-inhibitor (enalapril) resulted in the prompt resolution of the proteinuria. Interestingly, proteinuria relapsed after removing the ACE-inhibition. These observations suggest a causal relation between the overactivity of the renin-angiotensin system in this patient and his proteinuria.