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Effect of NSAIDs, ACE inhibitors and ARB on kidneys 

TomHan
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NSAIDs cause vasoconstriction of afferent arterioles
Effect:
Reduce GFR
Reduce blood perfusion to renal cells leading to ischaemia
ACEi and ARB
Blocks the effect of angiotensin (acts to constrict efferent arterioles)
Net effect: Dilation of efferent arterioles
Renal protective in Diabetes with early stage renal disease
Reduces the effect of hyaline arteriolosclerosis which narrows the efferent arterioles by dilating the efferent arterioles. Preventing hyperfiltration and glomerulosclerosis
Harmful in renal artery stenosis and late CKD (Chronic kidney disease where there is extensive glomerulosclerosis) by further reducing GFR.

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26 май 2019

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Комментарии : 19   
@yiguy5ed6ugh8h7
@yiguy5ed6ugh8h7 7 месяцев назад
The best explanation ever thank you so much
@harveenkaur1713
@harveenkaur1713 Год назад
the most straightforward explanation I have found! thank you!!
@thefunctionalfarmacista7790
@thefunctionalfarmacista7790 2 года назад
Excellent video/education!
@justafanof1925
@justafanof1925 2 года назад
Wow. Another medical knowledge. Feels so good to learn.
@zoehamilton4555
@zoehamilton4555 2 года назад
This was really well explained, thank you!
@singuyen800
@singuyen800 2 года назад
Thanks for the video
@prathipatirambabu2597
@prathipatirambabu2597 3 года назад
good analysis
@spottydawgful
@spottydawgful 5 лет назад
This is a great straightforward synopsis of Nsaid Ace and Arbs and renal disease. Thanks
@harshparikh7
@harshparikh7 4 года назад
Great explanation!! ACE-I can be renally protective or harmful depending on context. Clarified a lot, thank you!
@anjayyadav6735
@anjayyadav6735 3 года назад
Well explained. ..
@manjushreeinamdar1242
@manjushreeinamdar1242 2 года назад
Pls make more videos!!!
@mhmooodkhaaalill1515
@mhmooodkhaaalill1515 4 года назад
Good explaination
@stephanieng2130
@stephanieng2130 3 года назад
Great explanation yo ! ;)
@amuchilaniwaniwa4799
@amuchilaniwaniwa4799 Год назад
You seem not sure about how ACE causes AKI
@ml-ed4sc
@ml-ed4sc 3 года назад
so shouldn't all type 2 diabetics be on a low dose ACE/ARB before any kidney damage is detected? it seems like it should be standard treatment at first diagnosis of T2D ( assuming they don't have late stage renal disease, which they probably won't at first diagnosis.).
@TomHan96
@TomHan96 3 года назад
Your idea is plausible theoretically. However all medications have side effects, some people might experience them, some might not. We weigh the benefits and harms before prescribing someone medications. ACE inhibitors might cause hypotension in a diabetic with a normal blood pressure. It may cause annoying side effects like a dry cough in certain populations. Research need to be done to justify the cost and risk of giving the medication for prophylaxis of kidney damage in diabetics without hypertension. I would say the better approach would be to advise dietary changes (low carb, low sugar) and exercise first to treat the underlying diabetes rather than adding more medications.
@TomHan96
@TomHan96 3 года назад
In line with your idea, the current recommendation is that diabetics with hypertension would benefit from a trial of an ACE-i as the first line drug because it helps with both the hypertension and gives some renal protection at the same time.
@TomHan96
@TomHan96 3 года назад
Also your proposed 'low dose' needs to be tested to see if it has any physiological effect on the body or any practical benefit. Too low of a dose and the medication might not actually do anything to the body at all and it becomes like homeopathy which isn't proven.
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