Guest guest Posted July 11, 2003 Report Share Posted July 11, 2003 Dear k, I can't give you a perfect explanation but ACEs are great as long as the serum creatinine is below a certain level. Not sure what the cut off is. If the serum creatinine goes up past a certain point, it can cause problems and make the serum creatinine go up even more. I'm sure someone else can give you more details. My nephrologist said that it was normal that mine went up .1 after being put on an ACE and he said it usually stablizes after awhile. Mine has stayed at 1.1 for more than a year on the ACE. I take Altace. Take care, Rotghi k Venden wrote: > I was reading a drug book that I have in the house, and I stumbled upon > something interesting. In every reference to Ace Inhibitors it states > that > this type of drug may cause kidney damage and that blood creatinine levels > need to be checked prior to prescribing and also checked again > occassionally > during use. The doctor has me on an Ace inhibitor called Coversyl > 4mg. Why > is it that people who have kidney problems are routinely given Ace > inhibitors when these drugs can cause kidney problems? I would really > appreciate your opinions. > > Thanks, > > Pdt. (Rev). k Venden > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 11, 2003 Report Share Posted July 11, 2003 Great explanation Pierre - are you sure you're not a nephrologist? Rotghi Pierre L (groups) wrote: > They may rarely cause kidney problems. However, many studies and clinical > trials have shown that ACE inhibitors can slow progression of both > diabetic > and non-diabetic nephropathies (of which IgAN is one). Typically, serum > creatinine will increase a bit when you start an ACE inhibitor (or most BP > meds for that matter), and then it will stabilise. This is because if you > decrease blood pressure, you decrease the amount of blood going > through the > nephrons at any given time, so filtration goes down as a result. This may > seem counterproductive, but it's better for blood pressure to be lower in > the long run, and the slight rise in creatinine is of no significance. > > When there's something wrong with the nephrons, the kidneys have the > ability > to raise your blood pressure by increasing secretion of a hormone called > renin. They do this on purpose, precisely to *increase* the filtration - > more pressure in the glomeruli equals more filtration. However, while this > strategy works for the kidneys in the short term, it doesn't help them at > all in the long run (nor the rest of your body), because long term high > blood pressure will damage the glomeruli even more. > > Rarely, some people can be extremely sensitive to the effect of ACEI's. If > the rise in creatinine is 30% or more, then your nephrologist would > probably > stop it and put you on something else. > > Pierre > > Ace Inhibitors > > > > I was reading a drug book that I have in the house, and I stumbled upon > > something interesting. In every reference to Ace Inhibitors it states > that > > this type of drug may cause kidney damage and that blood creatinine > levels > > need to be checked prior to prescribing and also checked again > occassionally > > during use. The doctor has me on an Ace inhibitor called Coversyl 4mg. > Why > > is it that people who have kidney problems are routinely given Ace > > inhibitors when these drugs can cause kidney problems? I would really > > appreciate your opinions. > > > > Thanks, > > > > Pdt. (Rev). k Venden > > > > > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 11, 2003 Report Share Posted July 11, 2003 Hi k It's good to hear from you. My hunch is that your book might be overstating it's case. Ace inhibitors do affect the kidney - in a very special way. These drugs are given to kidney patients because of their reno-protective properties. Specifically, they lower blood pressure at the glomeruli. While it is true, in some instances that ACE inhibitors can cause a slight increase in creatinine, this is not due to a specific injury to the kidney and is reversible. My 12 year old is a good example. Shortly after he was diagnosed (MPGN, not IgAN), he started taking (among other things) cyclosporine and 25 mg of lisinopril. His creatinine almost doubled (in his case, that's not as dramatic as it sounds - it went from 0.6 to 1.1). The neph suggested that it was probably due to the drugs, rather than the kidney disease. She explained that given that despite the increase, the overall effect was for the greater good of the kidney. We ended up briefly going off the ACE inhibitor at one point and the creatinine went back down - and has stayed back down. Although I was a nervous wreck when the creatinine started going up, it is something I wouldn't give a second thought to now. Pierre can probably provide more insight than I. Cy Ace Inhibitors > I was reading a drug book that I have in the house, and I stumbled upon > something interesting. In every reference to Ace Inhibitors it states that > this type of drug may cause kidney damage and that blood creatinine levels > need to be checked prior to prescribing and also checked again occassionally > during use. The doctor has me on an Ace inhibitor called Coversyl 4mg. Why > is it that people who have kidney problems are routinely given Ace > inhibitors when these drugs can cause kidney problems? I would really > appreciate your opinions. > > Thanks, > > Pdt. (Rev). k Venden > > > > To edit your settings for the group, go to our Yahoo Group > home page: > http://groups.yahoo.com/group/iga-nephropathy/ > > To unsubcribe via email, > iga-nephropathy-unsubscribe > Visit our companion website at www.igan.ca. The site is entirely supported by donations. If you would like to help, go to: > http://www.igan.ca/id62.htm > > Thank you > > Quote Link to comment Share on other sites More sharing options...
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