saralasin and Kidney-Neoplasms

Topics: Adult; Angiotensin II; Animals; Female; Humans; Hypertension, Renal; Kidney Failure, Chronic; Kidney Neoplasms; Male; Middle Aged; Propranolol; Rats; Renin; Saralasin

Congestive heart failure is an unusual complication of the hyperreninemia of Wilms' tumors. Cases with bilateral tumors present a difficult management problem. This is a report of the successful medical management of a child with congestive heart failure secondary to hyperreninemia from bilateral Wilms' tumor. Hypertension and hyperreninemia were extensively documented. Their etiologic relation to the congestive heart failure was supported by the patient's improved cardiac function following specific renin-angiotensin blockade. With unilateral tumors, surgical excision corrects the hypertension; however, with large bilateral tumors, excision is out of the question. A unique feature of this case is the ability to control the blood pressure with saralasin. With subsequent antitumor therapy, renin concentrations decreased proportional to tumor size, and renin angiotensin blocking therapy could be discontinued.

Topics: Antineoplastic Combined Chemotherapy Protocols; Blood Pressure; Dactinomycin; Echocardiography; Heart Failure; Humans; Hypertension, Renal; Infant; Kidney Neoplasms; Male; Neoplasms, Multiple Primary; Renin; Renin-Angiotensin System; Saralasin; Ultrasonography; Vincristine; Wilms Tumor

Topics: Acebutolol; Adult; Aldosterone; Angiotensin II; Blood Pressure; Female; Half-Life; Humans; Hypertension; Kallikreins; Kidney Neoplasms; Renin; Saralasin