@@kristeenbarker potassium can go up though and damage the kidney but ACE dilates the vessels which helps with cardiac problems caused by CKD. Generally all types of minerals are bad for kidneys
@@kevinwellwrought2024ooo I was more thinking about preventing asystole. I’m not aware of any toxicity of high potassium to the kidneys, but of course low potassium can lead to interstitial damage to the kidneys. An interesting area for sure
@@kristeenbarker in fact, hyperkalemia can be a sign of kidney damage. High urea, uric acid, creatinin, sodium, phosphrous are also signs of CKD but these ones are well known. Main problem is proteinuria that decides the fate of our kidneys and creates all other renal problems.
52 yr old female with GFR hovering in the 110 range and creatinine .35 for the past 5 years. Taking Losartan 25mg once daily for 8 months. Flank pain so went to ER. (Maybe frequent urination in retrospect), No fever, no pain during urination, urine clear, and negative protein and negative urine culture X2. GFR was down to 66 and Creatinine 1.02. CT scan interpreted as Acute pyelonephritis. "Geographic areas of hypoattenuation present in relation to adjacent normally enhancing renal parenchyma suggestive of acute pylonephritis". I am on antibiotics and will be going to a urologist but my primary believes there is no infection. When an ARB causes poor kidney function, can it present with pain and abnormal CT scan?
Hello!! Whenever we prescribes ACE inhibitors or ARBs (such as losartan) we accept up to 30% reduced GFR as a sign that the drug is working. However anything more than that we would pause the medication and perform a work up for acute kidney injury - get to the bottom of that cause, treat it and then when the coast is clear and the renal function has normalised we would reintroduce the ACEinhibitor or ARB. I'm not at liberty to give medical advice here on youtube, so speaking in generalities here. Hope that helps! :).
That was a great video, thank you. Can you please tell us about managing the rising Creatinine in heart failure patients on diuretics. When to reduce the diuretics etc? Thank you.
Thank you so much for this clarification and the link to the article. I will share this with my peers.
Aw yay! I'm so excited it was helpful :) I hope it helps all your study buddies too
Nicely explained, thank you for this review! Greetings from an internal medicine resident from Brazil!
Brazil!!! That's so fun! Thank you so much for watching and please let me know if there's anything else i can create to help your studies :)
Well explained Thank you.
Thanks so much for watching - i'm so glad it was helpful! ;)
Thank you for this explanation! This topic has always confused me! Medical student here studying for my board exams in 2 weeks
Yes it's so confusing! I'm so glad we could help. How did the exam go? Sending all good vibes
ACE is good for heart
YESSS!!! Very True! So long as the potassium is under control they are great drugs!
@@kristeenbarker potassium can go up though and damage the kidney but ACE dilates the vessels which helps with cardiac problems caused by CKD. Generally all types of minerals are bad for kidneys
@@kevinwellwrought2024ooo I was more thinking about preventing asystole. I’m not aware of any toxicity of high potassium to the kidneys, but of course low potassium can lead to interstitial damage to the kidneys. An interesting area for sure
@@kristeenbarker in fact, hyperkalemia can be a sign of kidney damage. High urea, uric acid, creatinin, sodium, phosphrous are also signs of CKD but these ones are well known. Main problem is proteinuria that decides the fate of our kidneys and creates all other renal problems.
52 yr old female with GFR hovering in the 110 range and creatinine .35 for the past 5 years. Taking Losartan 25mg once daily for 8 months. Flank pain so went to ER. (Maybe frequent urination in retrospect), No fever, no pain during urination, urine clear, and negative protein and negative urine culture X2. GFR was down to 66 and Creatinine 1.02. CT scan interpreted as Acute pyelonephritis. "Geographic areas of hypoattenuation present in relation to adjacent normally enhancing renal parenchyma suggestive of acute pylonephritis". I am on antibiotics and will be going to a urologist but my primary believes there is no infection. When an ARB causes poor kidney function, can it present with pain and abnormal CT scan?
Hello!! Whenever we prescribes ACE inhibitors or ARBs (such as losartan) we accept up to 30% reduced GFR as a sign that the drug is working. However anything more than that we would pause the medication and perform a work up for acute kidney injury - get to the bottom of that cause, treat it and then when the coast is clear and the renal function has normalised we would reintroduce the ACEinhibitor or ARB. I'm not at liberty to give medical advice here on youtube, so speaking in generalities here. Hope that helps! :).
The trial has not made us wiser
Your accent is so strong I can’t understand you at all.
Aw that's a shame. Thanks for stopping by anyways. My best wishes for your studies
That was a great video, thank you. Can you please tell us about managing the rising Creatinine in heart failure patients on diuretics. When to reduce the diuretics etc? Thank you.
Oh my goodness this is such a great idea!!! Yes!!!