Late-onset renal failure from angiotensin blockade (LORFFAB) in 100 CKD patients

International Urology and Nephrology
M A C Onuigbo, N T C Onuigbo

Abstract

Notwithstanding proven renoprotection from RAAS blockade (AB) with ACE inhibitors and ARBs, and despite increasing utilization of AB in the US, we have continued to experience a CKD/ESRD epidemic. Given concerns for iatrogenic CKD/ESRD, we designed a prospective study to analyze the course of eGFR following withdrawal of AB in such patients. Between September 2002 and February 2005, all consecutive CKD patients on AB presenting with >25% increase in baseline serum creatinine were enrolled. eGFR following withdrawal of AB was monitored. The main outcome measures were serum creatinine, MDRD eGFR, and UA/Cr. 100 Caucasians, M:F=52:48, mean age 71.5 years were enrolled. Mean follow up was 26 months. Sixteen patients progressed to ESRD, of whom seven died. In 74, eGFR improved from 23.9+/-9 (7-47) to 39.2+/-15.4 (17-89) ml/min/1.73 m(2) BSA, 26.5 (3-46) months after stopping AB (P=0.001). The majority of the cohort, 95 patients, had known risk factors: 26 with RAS, 12 hypovolemia, 11 sepsis, 10 NSAIDs/cox II inhibitor use/abuse, 7 CIN, 2 congestive heart failure, 2 obstructive uropathy, and 27 with other medical and surgical causes, including malignancies, postoperative states, and infections. In the 26 with RAS, 5 with higher basel...Continue Reading

References

Oct 1, 1990·The Quarterly Journal of Medicine·P A KalraS Waldek
Oct 1, 1990·The Quarterly Journal of Medicine·A E Raine
Apr 20, 2000·The Medical Journal of Australia·M C Thomas
Sep 22, 2001·The New England Journal of Medicine·E J LewisUNKNOWN Collaborative Study Group
Sep 22, 2001·The New England Journal of Medicine·B M BrennerUNKNOWN RENAAL Study Investigators
Jan 25, 2003·Diabetes, Obesity & Metabolism·M Onuigbo, M R Weir
Sep 19, 2003·Lancet·Marc A PfefferUNKNOWN CHARM Investigators and Committees
Oct 9, 2003·JAMA : the Journal of the American Medical Association·Yujiro Kida
Oct 9, 2003·JAMA : the Journal of the American Medical Association·Macaulay A C Onuigbo
Dec 20, 2005·International Urology and Nephrology·Tushar J VachharajaniLaurence R I Baker
Mar 7, 2006·Kidney International·S SuissaA Kezouh
Sep 22, 2006·Kidney International·M A C Onuigbo, N T C Onuigbo

❮ Previous
Next ❯

Citations

Oct 13, 2009·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Aimun K AhmedA Meguid El Nahas
Aug 19, 2010·International Journal of Clinical Practice·M A C Onuigbo
Aug 19, 2010·International Journal of Clinical Practice·P A Swift, P A Andrews
Dec 3, 2011·Nephron. Clinical Practice·Anderson Roman GonçalvesMeguid El Nahas
May 30, 2009·Vascular Health and Risk Management·Gianpaolo ReboldiPaolo Verdecchia
May 24, 2014·International Journal of Clinical Practice·K JamesonD O'Donoghue
Apr 16, 2016·The Journal of Clinical Hypertension·Martin ChaumontJean-Michel Hougardy
Dec 19, 2012·Nature Reviews. Nephrology·Hiddo J Lambers HeerspinkGerjan J Navis
Sep 28, 2016·Environmental Monitoring and Assessment·Harsimran KaurGaganjyot Kaur
May 8, 2021·The American Journal of Medicine·Macaulay Amechi Chukwukadibia Onuigbo

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.