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Renin-angiotensin-aldosterone system blockade effects on the kidney in the elderly: benefits and limitations.
Clin J Am Soc Nephrol. 2010 Jul; 5(7):1330-9.CJ

Abstract

The proportion of the population that is elderly (age>or=65 years) is growing across the world. The increasing longevity of humans results in a higher number of elderly patients' presenting with multiple chronic diseases such as hypertension, diabetes, and chronic kidney disease (CKD). These problems increase morbidity and mortality in the elderly. Overactivity of the renin-angiotensin-aldosterone system (RAAS) is associated with the development of hypertension, cardiovascular events, and CKD, so targeting the RAAS is a logical therapeutic approach. Elderly patients present special concerns regarding the benefits versus risks of using RAAS blockers. Plasma renin activity declines with age, which has been attributed to the effect of age-associated nephrosclerosis. Plasma aldosterone is also reduced with age, resulting in a greater risk for hyperkalemia in older individuals, especially when coupled with the age-associated decline in GFR. Moreover, the elderly have a higher frequency of concurrent conditions and are on many medications, which may further increase the risk for adverse effects of RAAS blocking agents. Unfortunately, there is a paucity of literature that is specifically aimed at studying elderly using the RAAS blockers. We present in our in-depth review data regarding benefits and limitations of the use of the RAAS blockades on the various sites along the RAAS pathway for elderly patients. Specific attention was given to the role of combination RAAS blockade therapy and higher monotherapy dosing in the treatment of hypertension in the elderly.

Authors+Show Affiliations

Department of Medicine, University of Virginia Health System, P.O. Box 800133, Charlottesville, VA 22908, USA. turgutfaruk@yahoo.comNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

20498247

Citation

Turgut, Faruk, et al. "Renin-angiotensin-aldosterone System Blockade Effects On the Kidney in the Elderly: Benefits and Limitations." Clinical Journal of the American Society of Nephrology : CJASN, vol. 5, no. 7, 2010, pp. 1330-9.
Turgut F, Balogun RA, Abdel-Rahman EM. Renin-angiotensin-aldosterone system blockade effects on the kidney in the elderly: benefits and limitations. Clin J Am Soc Nephrol. 2010;5(7):1330-9.
Turgut, F., Balogun, R. A., & Abdel-Rahman, E. M. (2010). Renin-angiotensin-aldosterone system blockade effects on the kidney in the elderly: benefits and limitations. Clinical Journal of the American Society of Nephrology : CJASN, 5(7), 1330-9. https://doi.org/10.2215/CJN.08611209
Turgut F, Balogun RA, Abdel-Rahman EM. Renin-angiotensin-aldosterone System Blockade Effects On the Kidney in the Elderly: Benefits and Limitations. Clin J Am Soc Nephrol. 2010;5(7):1330-9. PubMed PMID: 20498247.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Renin-angiotensin-aldosterone system blockade effects on the kidney in the elderly: benefits and limitations. AU - Turgut,Faruk, AU - Balogun,Rasheed A, AU - Abdel-Rahman,Emaad M, Y1 - 2010/05/24/ PY - 2010/5/26/entrez PY - 2010/5/26/pubmed PY - 2010/10/27/medline SP - 1330 EP - 9 JF - Clinical journal of the American Society of Nephrology : CJASN JO - Clin J Am Soc Nephrol VL - 5 IS - 7 N2 - The proportion of the population that is elderly (age>or=65 years) is growing across the world. The increasing longevity of humans results in a higher number of elderly patients' presenting with multiple chronic diseases such as hypertension, diabetes, and chronic kidney disease (CKD). These problems increase morbidity and mortality in the elderly. Overactivity of the renin-angiotensin-aldosterone system (RAAS) is associated with the development of hypertension, cardiovascular events, and CKD, so targeting the RAAS is a logical therapeutic approach. Elderly patients present special concerns regarding the benefits versus risks of using RAAS blockers. Plasma renin activity declines with age, which has been attributed to the effect of age-associated nephrosclerosis. Plasma aldosterone is also reduced with age, resulting in a greater risk for hyperkalemia in older individuals, especially when coupled with the age-associated decline in GFR. Moreover, the elderly have a higher frequency of concurrent conditions and are on many medications, which may further increase the risk for adverse effects of RAAS blocking agents. Unfortunately, there is a paucity of literature that is specifically aimed at studying elderly using the RAAS blockers. We present in our in-depth review data regarding benefits and limitations of the use of the RAAS blockades on the various sites along the RAAS pathway for elderly patients. Specific attention was given to the role of combination RAAS blockade therapy and higher monotherapy dosing in the treatment of hypertension in the elderly. SN - 1555-905X UR - https://www.unboundmedicine.com/medline/citation/20498247/Renin_angiotensin_aldosterone_system_blockade_effects_on_the_kidney_in_the_elderly:_benefits_and_limitations_ L2 - https://cjasn.asnjournals.org/cgi/pmidlookup?view=long&pmid=20498247 DB - PRIME DP - Unbound Medicine ER -