Renal Artery Stenosis

Renal artery stenoses lead to a restriction of renal blood flow, which is counteracted by effective mechanisms such as the Bayliss effect. The administration of an ACE inhibitor in this initial situation can lead to initial hypotension (strongly stimulated RAA system) and to a significant functional restriction of the kidney (sharp increase in serum creatinine levels) up to kidney failure. The changes in renal function are reversible after discontinuation of the ACE inhibitor. In case of renal insufficiency the dose must be adjusted.