Nonoliguric Acute Renal Failure After Captopril Therapy

In a patient with severe renovascular hypertension, nonoliguric acute renal failure developed after she received captopril treatment. We believe this to be a previously unreported complication. Urine volume ranged from 1,640 to 2,260 mL/24 hr, and serum creatinine level rose from 2.3 to 8.3 mg/dL. There was no evidence of renal hypoperfusion or interstitial nephritis. Acute renal failure most likely was secondary to the nephrotoxic effect of captopril on chronically hypoperfused kidneys. Renal function improved rapidly after withdrawal of the drug therapy.