A 55-year-old male patient presented with azotemia and subnephrotic proteinuria with a serum creatinine of 3.2 mg/dl and protein creatinine ratio of 1.1 mg/dl in July 2015. He was a known hypertensive. Ultrasound showed normal sized kidneys with increased echoes. His renal biopsy revealed AERD. There was no history of prior invasive procedures.
In May 2017, a 73-year-old male patient developed breathlessness. His echocardiography study showed global hypokinesia and ejection fraction of 45%. Cardiac angiogram was done and was started on aspirin. His creatinine increased from 1.7 mg/dl to 9.6 mg/dl. He was started on hemodialysis. He was diagnosed as having AERD by renal biopsy.