Takayasu arteritis-associated refractory hypertension induces nephrotic syndrome through glomerular microangiopathy

Tomoya Nakayamada; Kensei Taguchi; Chikei Natori; Nao Nakamura; Makiko Fujii; Yuya Yamashita; Sakuya Ito; Kei Fukami

doi:10.1007/s13730-024-00952-5

Takayasu arteritis-associated refractory hypertension induces nephrotic syndrome through glomerular microangiopathy

CEN Case Rep. 2024 Dec 9. doi: 10.1007/s13730-024-00952-5. Online ahead of print.

Authors

Tomoya Nakayamada¹, Kensei Taguchi^{2

3}, Chikei Natori¹, Nao Nakamura¹, Makiko Fujii¹, Yuya Yamashita¹, Sakuya Ito¹, Kei Fukami¹

Affiliations

¹ Division of Nephrology, Department of Medicine, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, 830-0011, Japan.
² Division of Nephrology, Department of Medicine, Kurume University School of Medicine, 67 Asahi-Machi, Kurume, 830-0011, Japan. taguchi_kensei@kurume-u.ac.jp.
³ Research Institute of Medical Mass Spectrometry, Kurume University School of Medicine, Kurume, 830-0011, Japan. taguchi_kensei@kurume-u.ac.jp.

PMID: 39648265
DOI: 10.1007/s13730-024-00952-5

Abstract

Takayasu arteritis (TAK) is a systemic inflammatory condition characterized by vasculitis in mainly the aorta and their branches; however, few reports have demonstrated glomerulonephritis and subsequent nephrotic syndrome in patients with TAK. We encountered a 69-year-old woman with TAK who developed nephrotic syndrome owing to uncontrolled hypertension. Kidney biopsy demonstrated endotheliosis, aberrant proliferation of vascular smooth muscle cells, and concentric intimal hyperplasia without any clues of vasculitis. Treatment with sacubitril/valsartan reduced proteinuria and increased serum albumin without affecting renal function, which continued to suppress blood pressure and prevent recurrence of nephrotic syndrome over 2 years.

Keywords: ARNI; Glomerular microangiopathy; Hypertension; Sacubitril/valsartan; Takayasu arthritis.