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Note on Meds

Too much of a good thing?

Blockade of the renin-angiotensin-aldosterone system (RAAS) has been the cornerstone medication approach (along with controlling blood pressure) to prevent progression of renal disease. However, studies looking at the simultaneous use of two classes of agents, angiotensin receptor blockers (ARBs) and angiotensin-converting-enzyme inhibitors (ACEIs) have shown no additional benefit, and perhaps some harm. This study looked at the addition of a third class of agent, aliskiren, to either an ARB or an ACEI, and also saw no additional benefit. An accompanying commentary suggests that we may have reached a ceiling for the treatment blockade of the RAAS. It is also worth noting that this is one more study telling us that reduction of microalbuminuria does not translate into benefits for renal function.

Here is the abstract and a link to the commentary

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