scholarly journals Short-term suppression of the renin-angiotensin system in mice associated with hypertension during pregnancy

2012 ◽  
Author(s):  
Akiyoshi Fukamizu
Keyword(s):  
Renin Angiotensin System ◽  
Short Term ◽  
Angiotensin System ◽  
Renin Angiotensin

Early Renin-angiotensin System Blockade Improved Short-term and Longterm Renal Outcomes in Systemic Lupus Erythematosus Patients with Antiphospholipid-associated Nephropathy

2018 ◽  
Vol 45 (5) ◽  
pp. 655-662 ◽  
Author(s):  
Cai Yue ◽  
Guanhong Li ◽  
Yubing Wen ◽  
Xuemei Li ◽  
Ruitong Gao
Keyword(s):  
Lupus Erythematosus ◽  
Kidney Biopsy ◽  
Renin Angiotensin System ◽  
Systemic Lupus ◽  
Short Term ◽  
Angiotensin System ◽  
Renin Angiotensin ◽  
Raas Blockade ◽  
Significant Difference ◽  
Kidney Disease Progression

Objective.To investigate the renal protective effects of early renin-angiotensin-aldosterone system (RAAS) blockade with renin-angiotensin system inhibitors (RASI) in systemic lupus erythematosus (SLE) patients with antiphospholipid-associated nephropathy (aPLN).Methods.Medical data of 57 SLE patients with biopsy-proven aPLN were analyzed. Early RAAS blockade was defined as administration of RASI within 3 months after kidney biopsy and continued for ≥ 12 months.Results.There was no significant difference in demographic data, laboratory findings, and renal histology by the time of kidney biopsy, except that the RASI group had higher proteinuria levels vs the non-RASI group [5.2 (2.8–8.8) vs 1.9 (0.6–2.8) g/d, p = 0.005, respectively] and higher prevalence of hypertension (75% vs 29%, p = 0.001, respectively). No significant difference between the 2 groups was observed in estimated glomerular filtration rate (eGFR), mean arterial pressure, and proteinuria level at 12 months after kidney biopsy. The improvement ratio of eGFR at 12 months was significantly higher in the RASI group versus the non-RASI group [26% (−5 to 86) vs −2% (−20 to 20), p = 0.028, respectively], and the rate of change in eGFR beyond 12 months was similar between the 2 groups. During a mean followup of 80 months, 4 (23%) patients in the non-RASI group and 3 (8%) patients in the RASI group developed kidney disease progression. Early RAAS blockade significantly decreased the risk of kidney disease progression [HR = 0.11 (0.02–0.59); p = 0.010]. Proteinuria and hypertension controls were similar between the 2 groups.Conclusion.Early RAAS blockade improved the short-term and longterm renal outcomes in SLE patients with aPLN. The renal protective effect of RASI was independent of its antihypertensive and antiproteinuric effects.

scholarly journals Effect of Renin-Angiotensin System Inhibitors on the Comparative Nephrotoxicity of NSAIDs and Opioids during Hospitalization

Kidney360 ◽  
2020 ◽  
Vol 1 (7) ◽  
pp. 604-613 ◽  
Author(s):  
Todd A. Miano ◽  
Michael G. S. Shashaty ◽  
Wei Yang ◽  
Jeremiah R. Brown ◽  
Athena Zuppa ◽  
...  
Keyword(s):  
Secondary Analysis ◽  
Renin Angiotensin System ◽  
Confounding By Indication ◽  
Short Term ◽  
Angiotensin System ◽  
Renin Angiotensin ◽  
Rate Difference ◽  
Inflammatory Drugs ◽  
Baseline Characteristics ◽  
The Difference

BackgroundNonsteroidal anti-inflammatory drugs (NSAIDS) are increasingly important alternatives to opioids for analgesia during hospitalization as health systems implement opioid-minimization initiatives. Increasing NSAID use may increase AKI rates, particularly in patients with predisposing risk factors. Inconclusive data in outpatient populations suggests that NSAID nephrotoxicity is magnified by renin-angiotensin system inhibitors (RAS-I). No studies have tested this in hospitalized patients.MethodsRetrospective, active-comparator cohort study of patients admitted to four hospitals in Philadelphia, Pennsylvania. To minimize confounding by indication, NSAIDs were compared to oxycodone, and RAS-I were compared to amlodipine. We tested synergistic NSAID+RAS-I nephrotoxicity by comparing the difference in AKI rate between NSAID versus oxycodone in patients treated with RAS-I to the difference in AKI rate between NSAID versus oxycodone in patients treated with amlodipine. In a secondary analysis, we restricted the cohort to patients with baseline diuretic treatment. AKI rates were adjusted for 71 baseline characteristics with inverse probability of treatment-weighted Poisson regression.ResultsThe analysis included 25,571 patients who received a median of 2.4 days of analgesia. The overall AKI rate was 23.6 per 1000 days. The rate difference (RD) for NSAID versus oxycodone in patients treated with amlodipine was 4.1 per 1000 days (95% CI, −2.8 to 11.1), and the rate difference for NSAID versus oxycodone in patients treated with RAS-I was 5.9 per 1000 days (95% CI, 1.9 to 10.1), resulting in a nonsignificant interaction estimate: 1.85 excess AKI events per 1000 days (95% CI, −6.23 to 9.92). Analysis in patients treated with diuretics produced a higher, albeit nonsignificant, interaction estimate: 9.89 excess AKI events per 1000 days (95% CI, −5.04 to 24.83).ConclusionsSynergistic nephrotoxicity was not observed with short-term NSAID+RAS-I treatment in the absence of concomitant diuretics, suggesting that RAS-I treatment may not be a reason to choose opioids in lieu of NSAIDs in this population. Synergistic nephrotoxicity cannot be ruled out in patients treated with diuretics.

Short-term modulation of the renin-angiotensin system does not alter plasma adrenomedullin concentration in humans

1998 ◽  
Vol 16 (Supplement) ◽  
pp. 2057-2062 ◽  
Author(s):  
Toshihiro Kita ◽  
Kazuo Kitamura ◽  
Kenji Kuwasako ◽  
Mari Kawamoto ◽  
Tanenao Eto
Keyword(s):  
Renin Angiotensin System ◽  
Short Term ◽  
Angiotensin System ◽  
Renin Angiotensin
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