Abstract
Blockers of the renin-angiotensin-aldosterone system (RAAS), such as angiotensin-converting
enzyme inhibitors and angiotensin receptor blockers are routinely used in patients
with chronic kidney disease because of their cardiovascular (CV) and renoprotective
effects. However, there are no uniform recommendations about RAAS blockers for CV
protection in the end-stage renal disease (ESRD) population other than the preferred
drug class for blood pressure control. This uncertainty stems from the fact that patients
with ESRD were generally excluded from randomized controlled trials evaluating the
cardioprotective benefits of RAAS blockers. It is important to weigh the potential
harms associated with the use of RAAS blockers, such as electrolyte disturbances and
worsening anemia, with their role in protection of residual kidney function, alleviation
of thirst and potential CV benefits. The objective of this review is to summarize
the current knowledge about the use of RAAS blockers in patients with ESRD.
Keywords
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Article info
Publication history
Accepted:
December 4,
2015
Received:
September 14,
2015
Footnotes
☆The authors have no financial or other conflicts of interest to disclose.
Identification
Copyright
© 2016 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.
