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Blockade of renin-angiotensin-aldosterone system in kidney and heart disease: how much do we need?
Acta Med Indones. 2008 Jan; 40(1):34-7.AM

Abstract

The renin-angiotensin-aldosterone system (RAAS) plays a pivotal role in both cardiac and renal injury. Inhibition of RAAS with either an angiotensin converting enzyme inhibitor (ACE-I) or an angiotensin receptor blocker (ARB) provides both cardiac and renal protection, which is independent and additive to the benefit obtained from lowering blood pressure (BP). The combination of an ACE-I and an ARB should be used only for proteinuric renal disease and not for BP reduction. Patients with proteinuria >1 g/day despite optimal BP control with maximal dose of ACE-I or ARB monotherapy may benefit from a combination therapy. Inhibition of aldosterone with spironolactone or eplerenone provides survival advantage in patients with low LV ejection fraction and may also have antiproteinuric effects. Until further information is available, the routine combined use of all three inhibitors of the RAAS cannot be recommended.

Authors+Show Affiliations

Department of Internal Medicine, Husada Hospital, Jl. Mangga Besar no.137, Jakarta. salimlimmd@yahoo.com

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

19054878

Citation

Lim, Salim. "Blockade of Renin-angiotensin-aldosterone System in Kidney and Heart Disease: How Much Do We Need?" Acta Medica Indonesiana, vol. 40, no. 1, 2008, pp. 34-7.
Lim S. Blockade of renin-angiotensin-aldosterone system in kidney and heart disease: how much do we need? Acta Med Indones. 2008;40(1):34-7.
Lim, S. (2008). Blockade of renin-angiotensin-aldosterone system in kidney and heart disease: how much do we need? Acta Medica Indonesiana, 40(1), 34-7.
Lim S. Blockade of Renin-angiotensin-aldosterone System in Kidney and Heart Disease: How Much Do We Need. Acta Med Indones. 2008;40(1):34-7. PubMed PMID: 19054878.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Blockade of renin-angiotensin-aldosterone system in kidney and heart disease: how much do we need? A1 - Lim,Salim, PY - 2008/12/6/pubmed PY - 2009/1/24/medline PY - 2008/12/6/entrez SP - 34 EP - 7 JF - Acta medica Indonesiana JO - Acta Med Indones VL - 40 IS - 1 N2 - The renin-angiotensin-aldosterone system (RAAS) plays a pivotal role in both cardiac and renal injury. Inhibition of RAAS with either an angiotensin converting enzyme inhibitor (ACE-I) or an angiotensin receptor blocker (ARB) provides both cardiac and renal protection, which is independent and additive to the benefit obtained from lowering blood pressure (BP). The combination of an ACE-I and an ARB should be used only for proteinuric renal disease and not for BP reduction. Patients with proteinuria >1 g/day despite optimal BP control with maximal dose of ACE-I or ARB monotherapy may benefit from a combination therapy. Inhibition of aldosterone with spironolactone or eplerenone provides survival advantage in patients with low LV ejection fraction and may also have antiproteinuric effects. Until further information is available, the routine combined use of all three inhibitors of the RAAS cannot be recommended. SN - 0125-9326 UR - https://www.unboundmedicine.com/medline/citation/19054878/Blockade_of_renin_angiotensin_aldosterone_system_in_kidney_and_heart_disease:_how_much_do_we_need L2 - http://www.inaactamedica.org/archives/2008/19054878.pdf DB - PRIME DP - Unbound Medicine ER -