USMLE Forums banner

ACE inhibitors Nephrotoxic or Nephroprotective

21248 Views 17 Replies 11 Participants Last post by  soni1075
In Goljan it is given,

that ACE inhibitors are beneficial in diabetic nephropathy cause they maintain renal perfusion beyond efferent arteriole and thereby supplying blood to kidney parenchyma.

but in UW its given ACE mediated nephrotoxity is due to :


  • Like
Reactions: 1
1 - 1 of 18 Posts
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 .
1 - 1 of 18 Posts
This is an older thread, you may not receive a response, and could be reviving an old thread. Please consider creating a new thread.