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Renin Angiotensin Aldosterone System Inhibitors in Chronic Kidney Disease: A Difficult Equation

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Abstract

Chronic kidney disease (CKD) is a global health problem and is strongly associated with hypertension (HTN) and impaired quality of life. Managing HTN with agents that block the renin angiotensin aldosterone system (RAAS) remains the gold standard, however there is a misleading impression that patients with impaired renal function or those receiving hemodialysis should not be treated with RAAS inhibitors. To date, only a few data in this field are available, given that this population subset is systematically excluded from many major clinical trials. The purpose of this review was to solve the difficult equation regarding the optimal use of RAAS blockade in patients with CKD.

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  1. Department of Cardiology, LAIKO General Hospital, Hypertension Excellence Centre-ESH, 17 Agiou Thoma Street, 11527, Athens, Greece

    Elias Sanidas, Dimitrios Papadopoulos, Michalis Chatzis, Maria Velliou & John Barbetseas

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Correspondence to Maria Velliou.

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Elias Sanidas, Dimitrios Papadopoulos, Michalis Chatzis, Maria Velliou, and John Barbetseas have no conflicts of interest to declare.

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Sanidas, E., Papadopoulos, D., Chatzis, M. et al. Renin Angiotensin Aldosterone System Inhibitors in Chronic Kidney Disease: A Difficult Equation. Am J Cardiovasc Drugs 21, 619–627 (2021). https://doi.org/10.1007/s40256-021-00467-9

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