RESUMO
Idiopathic nodular glomerulosclerosis (ING) is a rare condition characterized by poor renal prognosis. The pathophysiology remains incompletely understood. Histologically, it closely resembles diabetic nephropathy. The development of this disease seems to be influenced by factors such as metabolic syndrome, particularly hypertension and glucose intolerance, along with active smoking. We report a case of ING in an obese 71-year-old male patient who had a long history of untreated hypertension and smoking. The patient underwent conservative treatment involving the administration of an angiotensin-2 receptor antagonist and dapagliflozin, resulting in favorable disease progression. Additional therapeutic measures, such as discontinuation of smoking and efforts toward weight loss, are strongly advised. Furthermore, regular screening for diabetes in the follow-up is crucial, as it can play a pathophysiological role in the disease and may manifest at a later stage, as observed in our clinical case.
RESUMO
Hypertension is a common clinical problem in patients with cancer. This is explained by its high prevalence in the general population, by the improvement in life expectancy in oncology patients thanks to the progress of anti-cancer therapies, but also by cancer therapy, which is sometimes burdened with cardiovascular toxicity. Early detection of hypertension and proper management are crucial to ensure the continuation of oncology treatment and to protect patients from the consequences of hypertension. Renin-angiotensin system blockers and calcium channel blockers are the first-line treatments.
L'hypertension artérielle (HTA) est un problème clinique fréquent chez les patients atteints d'un cancer. Cela s'explique par sa prévalence déjà élevée dans la population générale, par l'amélioration de l'espérance de vie des patients oncologiques grâce aux progrès des thérapies anticancéreuses, mais également par l'utilisation de traitements oncologiques qui sont parfois grevés d'une cardiotoxicité. Un dépistage précoce de l'HTA et une prise en charge adéquate sont alors capitaux afin d'assurer la pérennité des soins oncologiques et protéger les patients des conséquences de l'HTA. Les bloqueurs du système rénine angiotensine et les anticalciques représentent les traitements de première ligne.