Page "ACE inhibitor" Paragraph 25
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Renal impairment is a significant adverse effect of all ACE inhibitors, but the reason is still unknown.
Some suggest it is associated with their effect on angiotensin II-mediated homeostatic functions, such as renal blood flow.
Renal blood flow may be affected by angiotensin II because it vasoconstricts the efferent arterioles of the glomeruli of the kidney, thereby increasing glomerular filtration rate ( GFR ).
Hence, by reducing angiotensin II levels, ACE inhibitors may reduce GFR, a marker of renal function.
To be specific, they can induce or exacerbate renal impairment in patients with renal artery stenosis.
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