Ace inhibitors
In diabetics - it has a reno protective effect. It delays renal damage . Delays not block.There is a difference . It will slow down the galloping effect of chronic DM on creatinine rise.Eventually , the DM will push up the creatinine values even though you have ace in place.
Separate from the above is that Ace inhibitors cause renal damage. A small rise in creatinine is tolerated.Hence after 1 week check creatinine level . If damage is not tolerable stop it and move on to another class of medications. If its tolerable and check over the next 2-3 weeks doing renal funtion weekly.
- if it is so. If after the first check a week later cretinine not affected - then no need to do follow up the following week.
In bilat renal artery stenosis - do NOT use ace at all . It will shut down the kidneys via decreased GFR .
In diabetics - it has a reno protective effect. It delays renal damage . Delays not block.There is a difference . It will slow down the galloping effect of chronic DM on creatinine rise.Eventually , the DM will push up the creatinine values even though you have ace in place.
Separate from the above is that Ace inhibitors cause renal damage. A small rise in creatinine is tolerated.Hence after 1 week check creatinine level . If damage is not tolerable stop it and move on to another class of medications. If its tolerable and check over the next 2-3 weeks doing renal funtion weekly.
- if it is so. If after the first check a week later cretinine not affected - then no need to do follow up the following week.
In bilat renal artery stenosis - do NOT use ace at all . It will shut down the kidneys via decreased GFR .
