Role of renin–angiotensin–aldosterone system inhibitors in heart failure and chronic kidney disease

Article Details

Authors
Namrata Singhania MD, Saurabh Bansal MD, Shreya Mohandas, Divya P Nimmatoori MD, Abutaleb A Ejaz MD, Girish Singhania MD

Article Type
Review

DOI
10.7573/dic.2020-7-3

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Abstract

Renin–angiotensin–aldosterone system (RAAS) inhibitors are the key medications for patients with heart failure and chronic kidney disease. Multiple randomized controlled trials have demonstrated their benefits in an outpatient setting for the treatment of chronic heart failure. Additional advantages in acute heart failure treatment during inpatient hospitalization are less clear but a small number of non-randomized studies have favored their use. Conditions that result in stoppage of RAAS inhibitors during inpatient stay are an increase in serum creatinine, hyperkalemia, and hemodynamic instability such as hypotension. The role of RAAS inhibitors in chronic kidney disease has also been documented in multiple randomized controlled trials, with their use in hypertension and proteinuria being unambiguous. This narrative review summarizes the role of RAAS inhibitors in acute and chronic heart failure and chronic kidney disease.

Keywords: acute heart failure, chronic heart failure, chronic kidney disease, renin–angiotensin–aldosterone system inhibitors, RAAS.

Citation: Singhania N, Bansal S, Mohandas S, Nimmatoori DP, Ejaz AA, Singhania G. Role of renin–angiotensin–aldosterone system inhibitors in heart failure and chronic kidney disease. Drugs in Context 2020; 9: 2020-7-3. DOI: 10.7573/dic.2020-7-3

Contributions: NS reviewed the literature, collected the data, and wrote the manuscript. SB, SM, DPN, AAE, and GS helped with data collection and critically reviewed the manuscript. All authors have reviewed the final version and approved the manuscript for publication. All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article and take responsibility for the integrity of the work as a whole.

Disclosure and potential conflicts of interest: The authors declare that they have no conflicts of interest relevant to this manuscript. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors is available for download at: https://www.drugsincontext.com/wp-content/uploads/2020/09/dic.2020-7-3-COI.pdf

Acknowledgements: None.

Funding declaration: There was no funding associated with the preparation of this article.

Copyright: Copyright © 2020 Singhania N, Bansal S, Mohandas S, Nimmatoori DP, Ejaz AA, Singhania G. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0 which allows anyone to copy, distribute, and transmit the article provided it is properly attributed in the manner specified below. No commercial use without permission.

Correct attribution: Copyright © 2020 Singhania N, Bansal S, Mohandas S, Nimmatoori DP, Ejaz AA, Singhania G. https://doi.org/10.7573/dic.2020-7-3. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 4.0.

Article URL: https://www.drugsincontext.com/role-of-renin-angiotensin-aldosterone-system-inhibitors-in-heart-failure-and-chronic-kidney-disease

Correspondence: Namrata Singhania, Mount Carmel East Hospital, 6001, E Broad St., Columbus, OH, 43213, USA. namrat09@gmail.com

Provenance: Invited; externally peer reviewed.

Submitted: 13 July 2020; Peer review comments to author: 17 August 2020; Revised manuscript received: 22 September 2020; Accepted: 23 September 2020; Publication date: 11 November 2020.

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