ACE inhibitors are contraindicated in bilateral renal aery stenosis, because -: (A) Angiotensin II has direct effect on GFR, (B) Enhances bradykinin action, (C) Hyperreninism affects renal parenchyma, (D) Affects prostaglandins
Answer is A. Ans. is 'a' i.e., Angiotensin II has direct effect on GFR o Patients with renal aery stenosis are dependent on efferent aeriolar vasoconstiction for maintenance of glomerular filtration pressure. Angiotensin II is responsible for vasoconstriction of efferent aeriole. o ACE inhibitors prevent the generation of Angiotensin II. This causes dilatation of efferent aerioles and fall in glomerular filtration pressure. This can ppt renal failure. o Therefore ACE inhibition are C/I in patients with bilateral renal aery stenosis.