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Effects of ACE inhibition on renal haemodynamics in essential hypertension and hypertension associated with chronic renal failure
- Source :
- Drugs. 41
- Publication Year :
- 1991
-
Abstract
- Angiotensin II has many actions in the kidney, including regulation and distribution of renal circulation and glomerular filtration, as well as effects on mesangial contraction and on the filtration coefficient. The reduction in circulating and intrarenal angiotensin II by angiotensin converting enzyme (ACE) inhibitors in essential hypertension is associated with a significant increase in renal blood flow and a decrease in filtration fraction, without changes in glomerular filtration rate. In addition, administration of ACE inhibitors can reduce proximal sodium reabsorption via changes in peritubular hydrostatic and oncotic forces resulting from the fall in postglomerular capillary resistance. In severe hypertension the state of the renal vasculature does not allow ACE inhibition to induce similar haemodynamic changes and, therefore, it cannot contribute to renal sodium handling that requires the recruitment of alternate mechanisms. In spite of this, ACE inhibitors may exert a protective effect on the renal function of patients with severe hypertension as well as in those with renal impairment, by lowering systemic and, probably, intraglomerular pressure, reducing proteinuria and slowing the progression of renal failure.
- Subjects :
- Adult
Male
medicine.medical_specialty
Hypertension, Renal
Adolescent
Angiotensin-Converting Enzyme Inhibitors
Blood Pressure
urologic and male genital diseases
Essential hypertension
Kidney
Renal Circulation
Enalapril
Internal medicine
Medicine
Humans
Pharmacology (medical)
Renal sodium reabsorption
biology
business.industry
Angiotensin-converting enzyme
Cilazapril
Middle Aged
medicine.disease
Angiotensin II
Filtration fraction
Pyridazines
medicine.anatomical_structure
Endocrinology
Pathophysiology of hypertension
Renal blood flow
Hypertension
biology.protein
Kidney Failure, Chronic
Female
business
Subjects
Details
- ISSN :
- 00126667
- Volume :
- 41
- Database :
- OpenAIRE
- Journal :
- Drugs
- Accession number :
- edsair.doi.dedup.....41be38b372fcf9513caccda233bbce67