Elevations in serum creatinine with RAAS blockade: why isn't it a sign of kidney injury?

Abstract

RAAS blockade exerts potent hemodynamic, antihypertensive, and antiinflammatory effects, and slows progression of kidney disease beyond that due to lowering of blood pressure. The benefit extends to those with advanced disease.

In spite of established benefit, ACEi and ARB therapy remains underutilized, in part due to concerns about acute deteriorations in renal function that result from interruption of the RAAS.

Keywords

• Acute kidney injury and dual RAAS blockade
• angiotensin 2 receptor blocker
• angiotensin-converting enzyme inhibitor
• renin-angiotensin system