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Angiotensin I convert ing enzyme inhibitors and angiotensin II receptor antagonists

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Clinical Nephrotoxins

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Over the last decade, the treatment of hypertension has changed dramatically from the concept of stepped care, advocated in the 1970’s, to the more individualized care preferred nowadays. This phenomenon was largely due to the recent development of new classes of antihypertensives, which made it possible to adequately lower blood pressure in most patients with only one or two antihypertensive drugs, thus avoiding the need for a combination of multiple drugs. One of these new drug classes, the angiotensin I convert ing enzyme inhibitors (ACEI), drew a lot of attention since these were aimed at inhibiting the formation of angiotensin II, a hormone thought to be involved in the origin of systemic hypertension.

In this chapter we first will discuss the undesirable aspects of these effects of ACEI and will show how most of these effects may be prevented by cautious use of the agents. Since the mechanisms of the ACEI-induced membra nous glomerulo pathy and interstitial nephritis are different from those causing the fall in GFR, we will discuss each separately.

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  1. Groningen University Medical Center Hanzeplein 1, Groningen, NL-9713, Netherlands

    Paul E. De Jong

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Editors and Affiliations

  1. Laboratory of Pathophysiology Universiteitsplein 1, University of Antwerp, Wilrijk, B-2610, Belgium

    Marc E. De Broe

  2. Division of Nephrology, Hypertension and Clinical Pharmacology, Oregon Health Sciences University, 3181 SW Sam Jackson Park Road, Portland, OR, 97201, USA

    George A. Porter

  3. Legacy Good Samaritan Hospital, 1015 NW 22nd Avenue, W004, Portland, OR, 97201, USA

    William M. Bennett

  4. Groupe Hôspitalier Pitié Salpétrière Service De Néphrologie 83, Boulevard de l′Hôpital, Paris, F-75013, France

    Gilbert Deray

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De Jong, P.E. (2008). Angiotensin I convert ing enzyme inhibitors and angiotensin II receptor antagonists. In: De Broe, M.E., Porter, G.A., Bennett, W.M., Deray, G. (eds) Clinical Nephrotoxins. Springer, Boston, MA. https://doi.org/10.1007/978-0-387-84843-3_20

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