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Ace Inhibitors & the Kidneys A A Jameson
CHF ! RENIN RENIN Or Diuretic Drop in perfusion and GFR
CHF ! Angiotensin II Vasocontriction Increases Glomerular Pressure and Filtration
CHF ! Angiotensin II CHF ! ACE Inh. C.O. Ace Inhibitors Can reverse this compensator y mechanism and shut down urine output You hope increased C.O. will restore flow
Early Diabetes Characterized by Hyperfiltration Normal A II tone
CHF ! Angiotensin II Diabetes post ACE Angiotensin constriction removed Hyperfiltration and damage reduced
CHF ! Angiotensin II CHF w/ renal function preserved by A II CHF w/ renal function preserved by A II Secondary benefit from Prostaglandin dilation on the supply side
CHF ! Angiotensin II PG
NSAID + ACE Drip The combination removes both the Prostaglandin dilation and the Angiotensin Efferent constriction
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