The patient was reviewed by a vascular surgeon. The major issue addressed was the fate of the function in the occluded kidney as his kidney had significant function. The patient had had a left aorto renal bypass graft. The SKGFR are shown below:

There appears to be preservation of function in the left with a decrement in the right. This may have been the result of the attempted angioplasty to the right upper vessel. Post-operatively the patient suffered an episode of pancreatitis after discharge but is at present well. Although now on two agents, the blood pressure is well controlled. The clinicians involved felt sufficiently confident for one of these agents to be an ACEI.