Nephrotic syndrome due to
renovascular hypertension is uncommon. We herein report a case of
nephrotic syndrome associated with unilateral atherosclerotic
renal artery stenosis. A 76-year-old woman who had been taking
antihypertensive medication for more than 15 years was referred to our hospital for treatment of uncontrolled
hypertension and massive
proteinuria in the nephrotic range. An abdominal bruit was heard, and laboratory findings showed high plasma
renin activity and
hypokalemia. Renal computed tomography angiography showed severe
stenosis of the ostium of the right renal artery and an atrophic right kidney. The left renal artery was normal and the left kidney was compensatorily enlarged. After admission, we started treatment with an
angiotensin II receptor blocker and subsequently performed percutaneous transluminal renal angioplasty with renal artery
stent placement. As a result, her blood pressure became well controlled and the massive
proteinuria disappeared. In addition, her stenotic-side renal
atrophy was resolved, concomitant with an improvement in her renal function. The contralateral renal
hypertrophy was also resolved.