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Deterioration in renal function associated with angiotensin converting enzyme inhibitor therapy is not always reversible
Author(s) -
DEVOY M. A. B.,
TOMSON C. R. V.,
EDMUNDS M. E.,
FEEHALLY J.,
WALLS J.
Publication year - 1992
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1111/j.1365-2796.1992.tb00622.x
Subject(s) - medicine , renal function , dialysis , angiotensin converting enzyme , creatinine , ace inhibitor , disease , kidney disease , cardiology , endocrinology , blood pressure
. Fifteen patients presented between January 1986 and January 1991 with deterioration in renal function coincident with the introduction of angiotensin converting enzyme inhibitors. There was evidence of extrarenal vascular disease in 12 patients and preexisting renal impairment in 13. Four patients remained dialysis‐dependent and died within 4 weeks of presentation. Five patients required short‐term dialysis. Serum creatinine remained above pre‐treatment values in seven patients. Conventional explanations of the decline in renal function with ACE inhibition do not account for irreversible decrements in renal function. Possible mechanisms for this observation and clinical guidelines to identify patients at risk are suggested. We conclude that these agents should be used with great care in patients in whom atherosclerotic vascular disease is likely.