Why ACE inhibitors are contraindicated in renal artery stenosis?

Angiotensin-converting enzyme inhibitors (ACEIs) are contraindicated in patients with bilateral renal artery stenosis due to the risk of worsening of renal function due to preferential efferent arteriolar vasodilation in the renal glomerulus due to inhibition of angiotensin II.
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[@valentino4574]

Good video. Straight to the point. God bless

[@MedicalSnippet]

thank you👍🏻

[@adaskowalski6533]

Nice, straightforward

[@MedicalSnippet]

thank you

[@atapirmoradi5858]

Thanks it is great presentation in minimum time

[@MedicalSnippet]

thank you

[@Afshu97]

Thank you soooo soon much

[@MedicalSnippet]

you're welcome

[@drazeem3527]

Too good

[@MedicalSnippet]

thank you

[@mazhariqbal-oi3ho]

Thanks ❤

[@MedicalSnippet]

you're welcome

[@sivatheertha2335]

Thankyou

[@MedicalSnippet]

you're welcome

[@dingdong436.]

Thanx❤

[@MedicalSnippet]

you're welcome

[@hudaahmed3098]

Bigggggggggg thanx
B/c i was have disterpanse

[@MedicalSnippet]

you're welcome

[@Polic4572]

Can't we use renin inhibitor...

[@MohammadAli-wj7ev]

Can we use ARBs? In this case?

[@MedicalSnippet]

better to avoid them also

[@zeyer8058]

How we can use this when the patient comes?We don't exactly know the patient have renal arter stenosis or not unless we can do ultrasound so is there any indicators such as kreatin ? We cant give the patient with high kreatin level or low gfr ?can we say that

[@MedicalSnippet]

yes renal function test and electrolytes, to be checked before starting ACE inhibitors. You can read this article for more details...
www.ncbi.nlm.nih.gov/pmc/articles/PMC3474612/

[@ricecakke]

If patient has unilateral renal stenosis, can we still use acei?

[@MedicalSnippet]

better to avoid

[@ayasaleh190]

Can you write the reason in the comments please 🙏

[@MedicalSnippet]

Efferent arteriole constriction by renin in renal artery stenosis, creates a pressure gradient between the afferent and efferent arteriole, this pressure gradient maintains the GFR, inspite of low renal blood perfusion due to renal a. stenosis. If ACE inhibitors are given, this compensatory mechanism, that is Renin secretion is blocked, and the efferent arteriole constriction doesn't happen, there will be no pressure gradient between afferent and efferent arteriole, so GFR decreases, leading to renal failure

[@poljakovaandrea2223]

Not clear to me at all

[@MedicalSnippet]

Efferent arteriole constriction by renin in renal artery stenosis, creates a pressure gradient between the afferent and efferent arteriole, this pressure gradient maintains the GFR, inspite of low renal blood perfusion due to renal a. stenosis. If ACE inhibitors are given, this compensatory mechanism, that is Renin secretion is blocked, and the efferent arteriole constriction doesn't happen, there will be no pressure gradient between afferent and efferent arteriole, so GFR decreases, leading to renal failure

[@laithrazzaq1]

It's not quite clear

[@MedicalSnippet]

Efferent arteriole constriction by renin in renal artery stenosis, creates a pressure gradient between the afferent and efferent arteriole, this pressure gradient maintains the GFR, inspite of low renal blood perfusion due to renal a. stenosis. If ACE inhibitors are given, this compensatory mechanism, that is Renin secretion is blocked, and the efferent arteriole constriction doesn't happen, there will be no pressure gradient between afferent and efferent arteriole, so GFR decreases, leading to renal failure. Hope it helps