Related Experiment Videos
[Renal function during treatment of chronic renal failure with angiotensin converting enzyme inhibitors]
M Heitmann1, K Rasmussen, J I Nielsen
1Medicinsk afdeling, Amtssygehuset Roskilde.
Insights
ACE-inhibitor treatment for cardiac failure generally preserves kidney function. However, patients with generalized atherosclerosis, indicated by nitrate use, face a higher risk of reduced kidney function during ACE-inhibitor therapy.
Area of Science:
- Cardiology
- Nephrology
- Pharmacology
Context:
- Cardiac failure management often involves ACE-inhibitors.
- Kidney function monitoring is crucial during such treatments.
- Concomitant conditions may influence treatment outcomes.
Purpose:
- To retrospectively assess the impact of ACE-inhibitors on kidney function in cardiac failure patients.
- To identify risk factors, such as diuretic use or generalized atherosclerosis, for kidney function decline.
Summary:
- Retrospective analysis of 87 cardiac failure patients treated with ACE-inhibitors.
- 11.9% experienced >30% S-creatinine increase; 10.7% had 20-30% increase.
- 72.6% maintained stable kidney function; diuretics were not a risk factor, but nitrates (indicating atherosclerosis) were.
Impact:
- Highlights the need for careful kidney function monitoring, especially in patients with generalized atherosclerosis.
- Suggests specific monitoring points: before, 1-2 weeks, and 2-3 months post-initiation.
- Informs clinical practice regarding ACE-inhibitor use in cardiac patients with comorbidities.
Abstract:
The effect on kidney function fo treatment of cardiac failure with ACE-inhibitors was examined retrospectively in a material of 87 consecutive patients. Furthermore, it was evaluated whether concomitant treatment with diuretics or existing generalised atherosclerosis as indicated by ongoing treatment with nitrates could be a risk factor concerning reduction of kidney function. In 11.9% of the patients an increase in S-creatinine of > 30% was observed during the first weeks of treatment. It was only necessary to stop treatment in two of these patients. In the remainder S-creatinine decreased again during ongoing treatment. In another 10.7% of patients an increase of 20-30% in S-creatinine was observed. Seventy-two point six percent of the patients had unchanged kidney function during treatment with an ACE-inhibitor. Ongoing treatment with diuretics did not seem to be a risk factor for developing reduced kidney function, whereas significantly more patients on treatment with nitrates, indicating generalised atherosclerosis, developed reduced kidney function during treatment with ACE-inhibitors. It is recommended to control kidney function before, one to two weeks and two to three months following initiation of treatment with ACE-inhibitors and to pay special attention to patients with generalised atherosclerosis.