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Efficacy of renin-angiotensin-aldosterone system blockades for acute phase hypertensive emergencies in patient complicating severe acute kidney injury. | LitMetric

AI Article Synopsis

  • The renin-angiotensin-aldosterone system (RAAS) plays a key role in causing hypertensive emergencies, yet clinical guidelines do not recommend RAAS blockers for treatment.
  • A 44-year-old woman with severe hypertension and complications like brain stem posterior reversible encephalopathy syndrome and acute kidney injury was initially treated with nitroglycerin, calcium channel blockers, and spironolactone.
  • After her kidney injury persisted, adding losartan potassium led to successful improvements in her blood pressure and kidney function, indicating that using RAAS inhibitors like ARBs and spironolactone early can help manage hypertensive emergencies effectively.

Article Abstract

Renin-angiotensin-aldosterone system (RAAS) is primarily involved with pathological mechanism of developing hypertensive emergencies. However, none of clinical practice guidelines mention RAAS blockers for the treatment of hypertensive emergencies. A 44 year-old woman presented with severe hypertension, brain stem posterior reversible encephalopathy syndrome and severe acute kidney injury (AKI). We started anti-hypertensive therapy with continuous intravenous nitroglycerin and oral calcium channel blocker (CCB) and spironolactone. Since severe AKI persisted despite this therapy, we administered losartan potassium, which resulted in improvement in her blood pressure and creatinine. Clinical course of our patient suggests that timely initiation of ARB and spironolactone for hypertensive emergencies could be beneficial in terms of blood pressure control and for protection of target organs from this condition.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8810968PMC
http://dx.doi.org/10.1007/s13730-021-00639-1DOI Listing

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