[Iatrogenic disease in elderly. Case report].

Longer life expectancy and modern diagnostic and therapeutic advances favoured the ever more frequent development of ischaemic nephropathy (IN) characterized by the presence of atherosclerotic stenosis in both renal arteries (ARAS); 7% of patients older than 65 years with cardiovascular risk factors have ARAS but the prevalence grows to 20% in patients with coronary artery disease, to 42% in patients with aorto-iliac disease and to 67.5% in patients with peripheral artery atherosclerotic disease. Moreover the patient is later diagnosed with IN until de-hydratation or treatment with angiotensin converting enzyme inhibitors or angiotensin-2-receptor inhibitors. This therapy may present a hazard for elderly patients with unsuspected atherosclerotic renovascular disease; the risk may grow if nonsteroidal anti-inflammatory drugs are associated. Long life expectancy, associated comorbidities, multi-medication and functional failures induce a high risk for iatrogenic disease in elderly.