Angiotensin-converting enzyme inhibitors and receptor blockers in heart failure and chronic kidney disease – Demystifying controversies
In clinical setting, congestive heart failure (CHF) and chronic kidney disease (CKD) often co-exist in patients due to common underlying predisposing factors. An intricate equilibrium between the cardiovascular and renal system is maintained through rennin angiotensin–aldosterone axis and autonomic...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
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Elsevier
2017-05-01
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| Series: | Indian Heart Journal |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0019483216303765 |
| _version_ | 1819094369087520768 |
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| author | Kader Muneer Anishkumar Nair |
| author_facet | Kader Muneer Anishkumar Nair |
| author_sort | Kader Muneer |
| collection | DOAJ |
| description | In clinical setting, congestive heart failure (CHF) and chronic kidney disease (CKD) often co-exist in patients due to common underlying predisposing factors. An intricate equilibrium between the cardiovascular and renal system is maintained through rennin angiotensin–aldosterone axis and autonomic nervous system. Consequent to favorable hemodynamic modification, angiotensin converting enzyme inhibitors (ACEI) and angiotensin receptor blocking (ARB) therapy have proven to be an indispensable aspect of heart failure management with morbidity and mortality benefit. Additionally, progression to end stage renal failure may be halted by renin angiotensin aldosterone system (RAAS) blockade in patients with preexisting renal dysfunction. However, concern over the safety of RAAS blockade in presence of renal impairment has led to profound underutilization of these drugs in CHF patients with renal insufficiency. This review aims to provide a simplified guide to pathophysiology and management options of this perplexing situation. |
| first_indexed | 2024-12-21T23:26:18Z |
| format | Article |
| id | doaj.art-2dbfbf7b400c45aa8e13007e38726572 |
| institution | Directory Open Access Journal |
| issn | 0019-4832 |
| language | English |
| last_indexed | 2024-12-21T23:26:18Z |
| publishDate | 2017-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Indian Heart Journal |
| spelling | doaj.art-2dbfbf7b400c45aa8e13007e387265722022-12-21T18:46:37ZengElsevierIndian Heart Journal0019-48322017-05-0169337137410.1016/j.ihj.2016.08.007Angiotensin-converting enzyme inhibitors and receptor blockers in heart failure and chronic kidney disease – Demystifying controversiesKader MuneerAnishkumar NairIn clinical setting, congestive heart failure (CHF) and chronic kidney disease (CKD) often co-exist in patients due to common underlying predisposing factors. An intricate equilibrium between the cardiovascular and renal system is maintained through rennin angiotensin–aldosterone axis and autonomic nervous system. Consequent to favorable hemodynamic modification, angiotensin converting enzyme inhibitors (ACEI) and angiotensin receptor blocking (ARB) therapy have proven to be an indispensable aspect of heart failure management with morbidity and mortality benefit. Additionally, progression to end stage renal failure may be halted by renin angiotensin aldosterone system (RAAS) blockade in patients with preexisting renal dysfunction. However, concern over the safety of RAAS blockade in presence of renal impairment has led to profound underutilization of these drugs in CHF patients with renal insufficiency. This review aims to provide a simplified guide to pathophysiology and management options of this perplexing situation.http://www.sciencedirect.com/science/article/pii/S0019483216303765Congestive heart failureChronic kidney diseaseACE inhibitorsAngiotensin receptor blockersCreatinine |
| spellingShingle | Kader Muneer Anishkumar Nair Angiotensin-converting enzyme inhibitors and receptor blockers in heart failure and chronic kidney disease – Demystifying controversies Indian Heart Journal Congestive heart failure Chronic kidney disease ACE inhibitors Angiotensin receptor blockers Creatinine |
| title | Angiotensin-converting enzyme inhibitors and receptor blockers in heart failure and chronic kidney disease – Demystifying controversies |
| title_full | Angiotensin-converting enzyme inhibitors and receptor blockers in heart failure and chronic kidney disease – Demystifying controversies |
| title_fullStr | Angiotensin-converting enzyme inhibitors and receptor blockers in heart failure and chronic kidney disease – Demystifying controversies |
| title_full_unstemmed | Angiotensin-converting enzyme inhibitors and receptor blockers in heart failure and chronic kidney disease – Demystifying controversies |
| title_short | Angiotensin-converting enzyme inhibitors and receptor blockers in heart failure and chronic kidney disease – Demystifying controversies |
| title_sort | angiotensin converting enzyme inhibitors and receptor blockers in heart failure and chronic kidney disease demystifying controversies |
| topic | Congestive heart failure Chronic kidney disease ACE inhibitors Angiotensin receptor blockers Creatinine |
| url | http://www.sciencedirect.com/science/article/pii/S0019483216303765 |
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