The effect of angiotensin converting enzyme inhibition on effective renal plasma flow in patients with diffuse renal parenchymal diseases and hypertension

Žeravica, Radmila; Stosić, Z; Ilinčić, Branislava; Crnobrnja, Veljko; Jakovljevic, Ana; Mijović, Romana

doi:10.2298/mpns1404078z

Cited by 2 publications

(2 citation statements)

References 11 publications

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“…In the presence of CKD, it is generally prudent to exercise caution regarding hazardous co-prescriptions and dietary habits that predispose to drug-drug and drug-nutrient interactions [23,83]. Preexisting renal function and parenchymal kidney disease influence subsequent renal status following ACEI initiation [84]. Yet, data are lacking on predictors of rise in serum creatinine (SCr) and the course following ACEI use.…”

Section: Angiotensin-converting Enzyme Inhibitors and Angiotensin Recmentioning

confidence: 99%

Tolerability of Antihypertensive Medications in Older Adults

Dharmarajan

2015

Drugs Aging

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Several guidelines for hypertension have recently undergone revisions to incorporate an approach providing choices of medications based on age, race, and specific situations where hypertension may co-exist with disorders such as diabetes, coronary artery disease, heart failure and chronic kidney disease. Initial recommendations include diuretics, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and calcium channel blockers; beta blockers are favored in some guidelines and are a choice in specific settings. Within the classes of drugs, several antihypertensive agents provide options. This review discusses antihypertensive drugs by class, including adverse effects and tolerability, with preferences in older adults and specific settings. Adverse drug events from antihypertensive medications are discussed by class and where applicable for specific agents. Data from select studies pertinent to tolerability and adverse effects are presented in tables for several classes of drugs. The rationale for nonadherence to medication is reviewed, including the roles played by tolerability and adverse drug effects. Antihypertensive therapy in typical settings in older adults is discussed; they include hypertension in association with impaired cognition, depression, diabetes, sexual dysfunction, and falls. The key to successful therapy and tolerability is to promote a healthy lifestyle in conjunction with medications as the approach, thereby also lowering the adverse drug effects. The eventual choice of the specific drug(s) is based on risks, benefits, and patient preferences, and is best tailored for each older adult.

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Section: Angiotensin-converting Enzyme Inhibitors and Angiotensin Recmentioning

confidence: 99%

Tolerability of Antihypertensive Medications in Older Adults

Dharmarajan

2015

Drugs Aging

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“…99m Tc‐MAG 3 replaced 123 I‐OIH as the radiopharmaceutical of choice for gamma camera imaging many years ago due to excellent imaging qualities, availability and low cost as well as the low radiation dose to the patient (Bubeck et al, 1990; Itoh, 2001; Rehling et al, 1995; Russell & Dubovsky, 1999; Russell et al, 1988). However, the possibility to perform accurate measurement of RPF remains highly relevant, as RPF decreases with kidney disease and may be altered secondary to administration of several pharmaceuticals (Itoh, 2001; Prowle et al, 2010; Zeravica et al, 2014). Measuring RPF using CIT is mostly reserved for research purposes whereas clinically, as for 99m Tc‐DTPA, 99m Tc‐MAG 3 has primarily been investigated with SIT (Rehling & Nielsen, 2000; Rehling et al, 1995; Russell & Dubovsky, 1999).…”

Section: Discussionmentioning

confidence: 99%

Technetium‐99m‐MAG3 and technetium‐99m‐DTPA: Renal clearance measured by the constant infusion technique – Old news?

Østergaard¹,

Langaa²,

Vrist³

et al. 2021

Clin Physio Funct Imaging

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Background Accurate, precise and straightforward methods for measuring glomerular filtration rate (GFR) and/or renal plasma flow (RPF) are still in demand today. The time‐consuming constant infusion technique (CIT) is the gold standard and preferred for research, whereas the simple, but less precise, single injection technique (SIT) is used in clinical settings. This study investigated the use of 99mTc‐DTPA and 99mTc‐MAG3 by CIT as a measure of renal function. We developed and evaluated a model to balance the primer dose and infusion rate in an attempt to obtain plasma steady state as quickly as possible. Methods 14 healthy subjects received 99mTc‐DTPA and 6 hypertensive patients received 99mTc‐MAG3 in a standardized protocol. All participants had an eGFR above 60 ml/min and none had fluid retention. An intravenous primer injection of the relevant tracer was followed by a sustained infusion over 4.5 h with the same radiopharmaceutical. Blood and urine samples were collected at fixed intervals. Results 99mTc‐DTPA clearance reached steady state after 210 min (plasma clearance 78 ± 18 ml/min, urine clearance 110 ± 28 ml/min), whereas 99mTc‐MAG3 clearance achieved steady state after 150 min (plasma clearance 212 ± 56 ml/min, urine clearance 233 ± 59 ml/min). Conclusion Constant infusion technique with fixed primer and infusion rate using 99mTc‐MAG3 is feasible for research purposes. The longer time for reaching plasma steady state using 99mTc‐DTPA makes CIT with this tracer less optimal. If the primer/sustained balance can be optimized, for example using a priori SIT information, 99mTc‐DTPA as tracer for CIT may also be feasible.

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The effect of angiotensin converting enzyme inhibition on effective renal plasma flow in patients with diffuse renal parenchymal diseases and hypertension

Cited by 2 publications

References 11 publications

Tolerability of Antihypertensive Medications in Older Adults

Tolerability of Antihypertensive Medications in Older Adults

Technetium‐99m‐MAG3 and technetium‐99m‐DTPA: Renal clearance measured by the constant infusion technique – Old news?

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