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Previous Topic | Next Topic  bilat renal stenosis-ACE-I contraindicat 




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Author4 Posts
  #1

can any one explain?bilateral renal stenosis-ACE-I are contraindicated because they cause efferent artery dilatation and may lead to renal failur......do not understand the reasoning.

  #2

Man, that is easy:
The glomerular filtration pressure is determined by three main variables:
• systemic blood pressure
• vasomotor tone in the afferent arteriole
• vasomotor tone in the efferent arteriole
In cases of bilateral renal artery stenosis (or unilateral stenosis if there is only one functional kidney):
• the glomerular filtration pressure is dependent on the
vasoconstriction of the efferent arteriole because the resistance of the afferent blood vessels has been pathologically increased
• vasoconstriction of the efferent arteriole is mediated by angiotensin II
• administration of an ACE inhibitor abolishes the vasoconstriction of the efferent arteriole resulting in an abrupt fall in the glomerular filtration rate
• the deterioration in renal function due to ACE inhibitors is usually reversible on stopping the drug


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  #3

got it,thanks for explaining.

  #4

nicely explained justice!









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