BP ACEi ARB in elderly
ACEi and ARB should be used with caution in the elderly.
ACEi ARB successfully:
Lower proteinuria
Increase kidney blood flow (important for PKD)
Lowers blood pressure
Helps with Vitamin D levels
Helps prevent arteriosclerosis even if BP is less than 130
NOTE: Do not stop your medication without your physician's consent as sudden stoppage of BP medication can lead to higher blood pressures, increased risk of stroke or other cardiovascular events and increased risk of sudden drop in kidney functioning.
Safety of combining angiotensin-converting-enzyme inhibitors with angiotensin-receptor blockers in elderly patients
A Canadian Study from Alberta of older patients mean age of 76.1 years. 32,000 new users; 1500 were on combined therapy without having documented proteinuria.ACE Inhibitor and Angiotensin Receptor-II Antagonist Prescribing and Hospital Admissions with Acute Kidney Injury: A Longitudinal Ecological Study
Nov 6, 2013. Original Study looking at UK hospital admissions from 2007-2011.ACE inhibitor use may be linked to kidney failure
The study does not show that the admissions were because of the number of these prescriptions, and only shows an association. The study also contained no information about individual patients and why they were taking the drugs. Some of the conditions these drugs are prescribed for are themselves a risk factor for Acute Kidney Injury AKI.ACE Plus ARB May Risk Renal Injury
Individuals (not PKD'rs) those who had hyperkalemia (an increase in potassium levels) were more apt to go on to renal failure and those who had two medications prescribed without prior documented proteinuria.I think the above study could be slanted. Other causes for renal failure not mentioned include:
hypertension
diabetes
injury kidney
"This occurred more often in older adults. 5 events per 1000 patients (especially older). The study was a 55 month study of 32,000
individuals. Doctors prescribed two medications. At the same time, the ACE inhibitor and ARB prescription rate at the general practice
level increased from 0.202 to 0.234 per 1,000 patients, a relative 16% increase. . .Both the drugs and the conditions for which they're
used have been associated with acute kidney injury."
ACE Inhibitors, Angiotensin-Receptor Blockers Tied to Increase in Kidney Admissions
"U.K. researchers examined national prescription and hospital admission data from April 2007 through March 2011. Nationwide, ACE-inhibitor and ARB prescriptions increased by about 16% – and admissions for acute kidney injury by 52% – over the study period."Rise in acute kidney injury could be tied to certain BP medications
"Using the regression model, the researchers predicted that 1,638 admissions for acute kidney injury would have been avoided had prescriptions for ACE inhibitors and receptor antagonists remained at the same rate as the first year of the study, equivalent to 14.8% of the total increase in admissions for acute kidney injury."