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Ace Inhibitors & the Kidneys

Ace Inhibitors & the Kidneys. A. A. Jameson. Afferent. Efferent. CHF !. Or Diuretic. RENIN. Drop in perfusion and GFR. CHF !. Vasocontriction Increases Glomerular Pressure and Filtration. Angiotensin II. CHF !. CHF !. Ace Inhibitors

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Ace Inhibitors & the Kidneys

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  1. Ace Inhibitors & the Kidneys A A Jameson

  2. Afferent Efferent

  3. CHF ! Or Diuretic RENIN Drop in perfusion and GFR

  4. CHF ! VasocontrictionIncreases Glomerular Pressure and Filtration Angiotensin II

  5. CHF ! CHF ! Ace Inhibitors Can reverse this compensatory mechanism and shut down urine output Angiotensin II You hope increased C.O. will restore flow  C.O. ACE Inh.

  6. Early Diabetes Characterized by Hyperfiltration Normal A II tone

  7. CHF ! Diabetes post ACE Angiotensin II Angiotensin constriction removed Hyperfiltration and damage reduced

  8. CHF ! Angiotensin II CHF w/ renal function preserved by A II Secondary benefit from Prostaglandin dilation on the supply side

  9. CHF ! Angiotensin II PG

  10. Drip NSAID + ACE The combination removes both the Prostaglandin dilation and the Angiotensin Efferent constriction

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