Medicine Science l Med-Science

International Medical Journal – ISSN : 2147-0634

Efficacy and safety of combined vs. single renin-angiotensin-aldosterone system blockade in chronic kidney disease

Efficacy and safety of combined vs. single renin-angiotensin-aldosterone system blockade in chronic kidney disease [English]
Mona A. Abdelrahman, Ashraf Genina, Amira S. A. Said, Mohamed E. A. Abdelrahim
Med-Science. 2016; 5(3): 751-7
» Abstract & References » PDF Fulltext» doi: 10.5455/medscience.2016.05.8458

Abstract
Hypertension and proteinuria are well-known predictors of chronic kidney disease (CKD) progression. Therapeutic interventions have different magnitude of albuminuria and hypertension. This study was designed to evaluate the efficacy and safety of combined vs. single renin-angiotensin-aldosterone system (RAAS) blockade in chronic kidney disease. Forty (28 female) patients with chronic kidney diseases were collected from nephrology outpatient clinic, internal medicine department, Beni Suef University hospital. They were divided randomly into 2 groups. Group A was 24 (20 females) patients treated with Enalapril, as angiotensin converting enzyme inhibitor (ACE-I) alone. Group B was 16 (8 females) patients treated with combination of Enalapril and Irbesartan, as angiotensin receptor blocker (ARB). All patients were subjected to full history taking; thorough clinical examination; certain laboratory tests and renal function tests at the start of the study, 1.5 and 3 months later. Proteinuria, urinary albumin/creatinine ratio (UACR), systolic blood pressure (SBP) and glomerular filtration rate (GFR) were significantly (p<0.001) decreased with dual therapy (ACE-I and ARB) compared to monotherapy. In return serum potassium level (Ser.K), serum creatinine level (Ser.Cr) were significantly increased (p<0.001) with dual therapy (ACE-I and ARB) compared to monotherapy. The hypotensive and antiproteinuric effect of RAAS inhibitors should be compared with hyperkalemia and rise in serum creatinine level when prescribed as monothrapy or combination in patients with CKD. Decision of usage of RAAS blockade should be made based on the risk and benefit ratio.

Key words: Renin-angiotensin-aldosterone system, proteinuria, chronic kidney disease (CKD), Angiotensin converting enzyme inhibitor (ACEI), angiotensin receptor blocker (ARB), dual therapy, renal failure, hypertension, diabetic nephropathy and dual RAAS blockade, combination

How to Cite this Article
Pubmed StyleAbdelrahman MA, Genina A, Said ASA, Abdelrahim MEA. Efficacy and safety of combined vs. single renin-angiotensin-aldosterone system blockade in chronic kidney disease. Med-Science. 2016; 5(3): 751-7. doi:10.5455/medscience.2016.05.8458


Web StyleAbdelrahman MA, Genina A, Said ASA, Abdelrahim MEA. Efficacy and safety of combined vs. single renin-angiotensin-aldosterone system blockade in chronic kidney disease. www.scopemed.org/?mno=211993 [Access: December 09, 2016].doi:10.5455/medscience.2016.05.8458


AMA (American Medical Association) StyleAbdelrahman MA, Genina A, Said ASA, Abdelrahim MEA. Efficacy and safety of combined vs. single renin-angiotensin-aldosterone system blockade in chronic kidney disease. Med-Science. 2016; 5(3): 751-7. doi:10.5455/medscience.2016.05.8458


Vancouver/ICMJE StyleAbdelrahman MA, Genina A, Said ASA, Abdelrahim MEA. Efficacy and safety of combined vs. single renin-angiotensin-aldosterone system blockade in chronic kidney disease. Med-Science. (2016), [cited December 09, 2016]; 5(3): 751-7.doi:10.5455/medscience.2016.05.8458


Harvard StyleAbdelrahman, M. A., Genina, A., Said, A. S. A. & Abdelrahim, M. E. A. (2016) Efficacy and safety of combined vs. single renin-angiotensin-aldosterone system blockade in chronic kidney disease. Med-Science, 5 (3), 751-7. doi:10.5455/medscience.2016.05.8458


Turabian StyleAbdelrahman, Mona A., Ashraf Genina, Amira S. A. Said, and Mohamed E. A. Abdelrahim. 2016. Efficacy and safety of combined vs. single renin-angiotensin-aldosterone system blockade in chronic kidney disease. Medicine Science | International Medical Journal, 5 (3), 751-7. doi:10.5455/medscience.2016.05.8458


Chicago StyleAbdelrahman, Mona A., Ashraf Genina, Amira S. A. Said, and Mohamed E. A. Abdelrahim. “Efficacy and safety of combined vs. single renin-angiotensin-aldosterone system blockade in chronic kidney disease.” Medicine Science | International Medical Journal 5 (2016), 751-7. doi:10.5455/medscience.2016.05.8458


MLA (The Modern Language Association) StyleAbdelrahman, Mona A., Ashraf Genina, Amira S. A. Said, and Mohamed E. A. Abdelrahim. “Efficacy and safety of combined vs. single renin-angiotensin-aldosterone system blockade in chronic kidney disease.” Medicine Science | International Medical Journal 5.3 (2016), 751-7. Print. doi:10.5455/medscience.2016.05.8458


APA (American Psychological Association) StyleAbdelrahman, M. A., Genina, A., Said, A. S. A. & Abdelrahim, M. E. A. (2016) Efficacy and safety of combined vs. single renin-angiotensin-aldosterone system blockade in chronic kidney disease. Medicine Science | International Medical Journal, 5 (3), 751-7.doi:10.5455/medscience.2016.05.8458

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