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Is there added value to adding ARB to ACE inhibitors in the management of CKD?
J Am Soc Nephrol. 2009 Aug; 20(8):1666-8.JA

Abstract

Antagonism of the rennin-angiotensin-aldosterone-system (RAAS) decreases BP and reduces proteinuria in chronic kidney disease. BP is decreased approximately 5 mmHg when angiotensin II blockers are added to angiotensin-converting enzyme (ACE) inhibitors and is less than typically seen when other agents are added to existing ACE inhibitor regimens. Dual RAAS blockade results in additional reduction in proteinuria. Clinically insignificant increases in hyperkalemia and modest decreases in GFR occur. Data regarding long-term preservation of renal function are lacking. We suggest dual RAAS blockade be used in patients with chronic kidney disease with residual proteinuria on maximal ACE inhibitor or angiotensin II blocker therapy, anticipating additional data with ongoing trials.

Authors+Show Affiliations

Renal, Electrolyte and Hypertension Division, Department of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA. debbie.cohen@uphs.upenn.eduNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18776118

Citation

Cohen, Debbie L., and Raymond R. Townsend. "Is There Added Value to Adding ARB to ACE Inhibitors in the Management of CKD?" Journal of the American Society of Nephrology : JASN, vol. 20, no. 8, 2009, pp. 1666-8.
Cohen DL, Townsend RR. Is there added value to adding ARB to ACE inhibitors in the management of CKD? J Am Soc Nephrol. 2009;20(8):1666-8.
Cohen, D. L., & Townsend, R. R. (2009). Is there added value to adding ARB to ACE inhibitors in the management of CKD? Journal of the American Society of Nephrology : JASN, 20(8), 1666-8. https://doi.org/10.1681/ASN.2008040381
Cohen DL, Townsend RR. Is There Added Value to Adding ARB to ACE Inhibitors in the Management of CKD. J Am Soc Nephrol. 2009;20(8):1666-8. PubMed PMID: 18776118.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Is there added value to adding ARB to ACE inhibitors in the management of CKD? AU - Cohen,Debbie L, AU - Townsend,Raymond R, Y1 - 2008/09/05/ PY - 2008/9/9/pubmed PY - 2009/9/2/medline PY - 2008/9/9/entrez SP - 1666 EP - 8 JF - Journal of the American Society of Nephrology : JASN JO - J Am Soc Nephrol VL - 20 IS - 8 N2 - Antagonism of the rennin-angiotensin-aldosterone-system (RAAS) decreases BP and reduces proteinuria in chronic kidney disease. BP is decreased approximately 5 mmHg when angiotensin II blockers are added to angiotensin-converting enzyme (ACE) inhibitors and is less than typically seen when other agents are added to existing ACE inhibitor regimens. Dual RAAS blockade results in additional reduction in proteinuria. Clinically insignificant increases in hyperkalemia and modest decreases in GFR occur. Data regarding long-term preservation of renal function are lacking. We suggest dual RAAS blockade be used in patients with chronic kidney disease with residual proteinuria on maximal ACE inhibitor or angiotensin II blocker therapy, anticipating additional data with ongoing trials. SN - 1533-3450 UR - https://www.unboundmedicine.com/medline/citation/18776118/Is_there_added_value_to_adding_ARB_to_ACE_inhibitors_in_the_management_of_CKD L2 - https://jasn.asnjournals.org/cgi/pmidlookup?view=long&pmid=18776118 DB - PRIME DP - Unbound Medicine ER -