why ace inhibitors are contraindicated in bilateral renal stenosis?
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Angiotensin-converting enzyme inhibitors (ACEIs) are contraindicated in patients with bilateral renal artery stenosis due to risk of azotemia resulting from preferential efferent arteriolar vasodilation in the renal glomerulus due to inhibition of angiotensin II.
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Possible causes of resistant hypertension Abnormalities in the hormones that control blood pressure. The accumulation of artery-clogging plaque in blood vessels that nourish the kidneys, a condition called renal artery stenosis.
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These high blood pressure medications block formation of a hormone that causes blood vessels to narrow, so vessels relax. ACE inhibitors may cause these side effects: A dry, hacking cough that doesn't go away. If you have this side effect, the doctor may prescribe another type of medication.
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Abstract. Lisinopril, like other ACE inhibitors, lowers blood pressure and preserves renal function in hypertensive patients with non-insulin-dependent or insulin-dependent diabetes mellitus (NIDDM or IDDM) and early or overt nephropathy, without adversely affecting glycaemic control or lipid profiles.
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(See "Major side effects of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers".) With respect to progression of the renal disease, ACE inhibitors and ARBs can cause a decline in renal function and a rise in serum potassium that typically occur one to two weeks after the onset of therapy.
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For example, ACE inhibitors, which are used to treat conditions such as high blood pressure, scleroderma and migraines, are not safe during pregnancy because they can damage the baby's kidneys. However, they are fine for a breastfeeding mother because these types of drugs do not cross into breast milk, Dr.
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ACE inhibitors and ARBs have been shown effective in preventing or at least slowing the process of renal disease in patients with diabetes by interfering with the renin-angiotensin system. ACE inhibitors and ARBs lower intraglomerular pressure by decreasing efferent arteriolar pressure.
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Renal artery disease: A blockage in the renal arteries can cause renal artery disease (stenosis). The symptoms include uncontrolled hypertension (high blood pressure), congestive heart failure, and abnormal kidney function.
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ACE inhibitors can be good and bad for your kidneys. These are medications that tend to end in “-il,” like lisinopril, enalapril, and ramipril. ACE inhibitors are popular drugs for high blood pressure and heart failure.
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Angiotensin-converting enzyme (ACE) inhibitors At present, and based on the available evidence, ACE inhibitors should probably not be used as first-line antihypertensive therapy in patients with COPD.
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ACE inhibitors are contraindicated in patients with a history of angioedema or hypersensitivity related to treatment with an ACE inhibitor and those with hereditary or idiopathic angioedema.
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However, when lisinopril, or any ACE inhibitor, is taken during the second or third trimesters of pregnancy, it can cause low levels of amniotic fluid (the fluid that surrounds the baby). Low levels of amniotic fluid can lead to health problems for the developing baby.
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In conditions in which glomerular filtration is critically dependent on angiotensin II-mediated efferent vascular tone (such as a post-stenotic kidney, or patients with heart failure and severe depletion of circulating volume), ACE inhibition can induce acute renal failure, which is reversible after withdrawal of the ...
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The rise in serum creatinine values usually begins a few days after beginning therapy with an ACE inhibitor or an ARB, as angiotensin II levels are rapidly reduced or blocked from binding. 6 This results in efferent arteriolar dilatation and decreased effective GFR.
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Avoid digitalis, because glycosides are contraindicated except in patients with uncontrolled atrial fibrillation. Cautious use of diuretics should be exercised because of their potential adverse effect on the LV outflow gradient and ventricular volume.
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['Abnormalities in the hormones that control blood pressure.', 'The accumulation of artery-clogging plaque in blood vessels that nourish the kidneys, a condition called renal artery stenosis.', 'Sleep problems, such as the breath-holding type of snoring known as obstructive sleep apnea.']
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['ACE inhibitors.', 'angiotensin-2 receptor blockers (ARBs)', 'beta blockers.', 'mineralocorticoid receptor antagonists.', 'diuretics.', 'ivabradine.', 'sacubitril valsartan.', 'hydralazine with nitrate.']