Our study shows that PTRA improved or preserved the renal function in most patients with normal to moderately impaired renal function. Close follow-up and possibly re-intervention are necessary to obtain satisfactory clinical and angiographical result.

Massive hemolysis and renal failure are rare complications of infection with Clostridium perfringens, resulting in a very high mortality rate (70-100%). The severity of the infection depends on the presence of underlying conditions such as malignancies and diabetes mellitus. In patients without underlying disorders, massive hemolysis and anuria have been observed in only eight cases, according to recent reports. This case report describes a 61-year-old man who died of C. perfringens septicemia with massive hemolysis and anuria less than 4 h after admittance to the hospital, despite rapid and adequate antibiotic treatment. No focal infection was found.

Lisinopril has been compared with slow-release nifedipine in a 16-week double-blind, randomized, parallel-group study involving 102 patients with mild to moderate hypertension. Sitting systolic and diastolic blood pressures were reduced 6 and 5 mmHg more by lisinopril than by nifedipine over 12 weeks monotherapy. After 12 weeks a greater proportion of patients taking lisinopril was controlled (sitting diastolic blood pressure below 95 mm Hg) than in those taking nifedipine. As a result, 17% of those taking lisinopril and 38% of those taking nifedipine required additional therapy with hydrochlorothiazide. The addition of hydrochlorothiazide resulted in similar response rates in the lisinopril and nifedipine groups (89% and 75% respectively). The rate of reporting of adverse events considered to be drug-related and the rate of withdrawals were similar for both treatments. Cough was more often reported with lisinopril and headache, sweating, and hot flushes with nifedipine. We conclude that once-daily titrated doses of lisinopril produced better control of blood pressure than twice-daily titrated doses of nifedipine.