Chronic Kidney Disease and RAAS Blockade: A New view of Renoprotection

Despite an increasing use of ACE inhibitors (ACEIs) and angiotensin receptor blockers (ARB) by tens of millions of chronic kidney disease (CKD) patients around the world for reno-protection, we have continued to witness global pandemics of acute renal failure, CKD and end-stage renal disease. While the mechanisms for these global pandemics remain speculative, there is accruing evidence of iatrogenic renal failure from ACEIs and ARBs. Since 2005, we have published an increasing number of such reports from our center. More complimentary reports from around the world have surfaced in recent years. We described two new syndromes - late onset renal failure from angiotensin blockade (LORFFAB) and the syndrome of rapid onset end-stage renal disease (SORO-ESRD). This book is an amalgam of all our work with new unpublished data. The contributions of LORFFAB and SORO-ESRD to the global pandemics warrant worldwide study. Finally, this work presents a very balanced review of the evidence base for reno-protection with ACEIs and ARBs and should be especially useful to medical professionals in Family Medicine, Internal Medicine, Nephrology and Hypertension, Emergency Medicine and Cardiology.