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Angiotensin-converting enzyme inhibitors and angiotensin II type 1 receptor blockers after renal transplantation

C Morath1, B Schmied, A Mehrabi

  • 1Department of Nephrology, University of Heidelberg, Heidelberg, Germany. christian.morath@med.uni-heidelberg.de

Clinical Transplantation
|November 26, 2009
PubMed

Insights

Renin-angiotensin system blockade benefits native kidney disease but its use post-renal transplant requires more evidence. This review examines its effects on transplant patients, considering risks and benefits.

Area of Science:

  • Nephrology
  • Transplantation Medicine
  • Cardiovascular Medicine

Background:

  • Renin-angiotensin system (RAS) blockade slows chronic kidney disease progression in native kidneys.
  • Post-renal transplant patients often have renal insufficiency and heart disease.
  • Evidence for RAS blockade use in renal transplant recipients is lacking.

Purpose of the Study:

  • To summarize evidence on RAS inhibitor use after renal transplantation.
  • To discuss potential benefits and adverse effects of RAS blockade in this population.
  • To review the impact of RAS blockade on transplant outcomes.

Main Methods:

  • Literature review of studies on RAS inhibitors post-renal transplantation.
  • Analysis of effects on morphologic and biochemical markers.
  • Assessment of impact on renal function, graft, and patient survival.

Main Results:

  • RAS blockade is established for native kidney disease.
  • Limited evidence exists for its routine use in renal transplant recipients.
  • Potential benefits and risks require careful consideration.

Conclusions:

  • Further research is needed to establish the role of RAS blockade post-renal transplant.
  • Individual patient factors must guide treatment decisions.
  • Balancing potential benefits against risks is crucial for optimal outcomes.

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