Friday, September 24, 2010

Q: Which one renal failure (crisis) is treated/managed by ACE inhibitor?


Answer: Scleroderma Renal Crisis!

Scleroderma Renal Crisis is one of the few rheumatological emergency where early diagnosis and treatment can make big difference in outcome. Wrong diagnosis may lead to wrong management pathway and eventually to very high mortality. SRC is heralded with hypertensive crisis associated with acute renal failure but the pearl is to avoid IV Labetolol or nitroprusside and gradually decrease blood pressure with PO angiotensin-converting enzyme (ACE) inhibitors. calcium channel blockers may help. Renal dialysis is a last resort. It has been suggested that use of steroids is associated with onset of scleroderma renal crisis
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