ace inhibitors & the kidneys
DESCRIPTION
Ace Inhibitors & the Kidneys. A. A. Jameson. Afferent. Efferent. CHF !. Or Diuretic. RENIN. Drop in perfusion and GFR. CHF !. Vasocontriction Increases Glomerular Pressure and Filtration. Angiotensin II. CHF !. CHF !. Ace Inhibitors - PowerPoint PPT PresentationTRANSCRIPT
Ace Inhibitors & the Kidneys
A A
Jameson
Afferent
Efferent
CHF !CHF !
RENINRENIN
Or Diuretic
Drop in perfusion and GFR
CHF !CHF ! Angiotensin II
VasocontrictionIncreases Glomerular Pressure and Filtration
CHF !CHF ! Angiotensin IICHF !CHF !
ACE Inh.
C.O.
Ace Inhibitors
Can reverse this compensatory mechanism and shut down urine output
You hope increased C.O. will restore flow
Early DiabetesEarly Diabetes
Characterized by Hyperfiltration
Normal A II tone
CHF !CHF ! Angiotensin II
Diabetes post ACEDiabetes post ACE
Angiotensin constriction removed
Hyperfiltration and damage reduced
CHF !CHF ! Angiotensin IICHF w/ renal function
preserved by A II
CHF w/ renal functionpreserved by A II
Secondary benefit from Prostaglandin dilation on the supply side
CHF !CHF ! Angiotensin II
PG
NSAID + ACENSAID + ACE
DripThe combination removes both the Prostaglandin dilation and the Angiotensin Efferent constriction