{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,31]],"date-time":"2025-08-31T10:33:52Z","timestamp":1756636432672},"reference-count":9,"publisher":"Oxford University Press (OUP)","issue":"883","license":[{"start":{"date-parts":[[1999,5,1]],"date-time":"1999-05-01T00:00:00Z","timestamp":925516800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[1999,5,1]]},"abstract":"<jats:title>Summary<\/jats:title>\n               <jats:p>A total of 187 heart failure patients aged 65\u201392 years, with pretreatment serum creatinine levels below 200 \u03bcmol\/l, were monitored for more than 12 months on angiotensin-converting enzyme (ACE) inhibitor therapy. Optimal ACE inhibitor dosage was found in 27% of patients, while a significant deterioration in renal function, characterised by &amp;gt;20% increase in serum creatinine to &amp;gt;200 \u03bcmol\/l, occurred in 25 patients. This was most closely attributable to ACE inhibitor treatment per se (implying co-existence of bilateral renal artery stenosis) in only four cases, including one in whom renal deterioration was reproducible on inadvertent rechallenge. In the other 21, renal deterioration was attributable to diuretic-related blood volume depletion (two cases), nonsteroidal anti-inflammatory drugs (two cases), obstructive uropathy (two cases), preterminal renal shutdown (two cases), and the interaction between diuretic and ACE inhibitor dosage (including long-acting vs short-acting drugs) (13 cases). This study could serve as the basis for future comparisons of ACE-inhibitor-related renal deterioration when the entry requirement is optimal ACE inhibitor dosage.<\/jats:p>","DOI":"10.1136\/pgmj.75.883.275","type":"journal-article","created":{"date-parts":[[2015,2,18]],"date-time":"2015-02-18T00:04:10Z","timestamp":1424217850000},"page":"275-277","update-policy":"http:\/\/dx.doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Evaluation of renal function in elderly heart failure patients on ACE inhibitors"],"prefix":"10.1093","volume":"75","author":[{"given":"O M P","family":"Jolobe","sequence":"first","affiliation":[{"name":"Department of Medicine for the Elderly, Tameside General Hospital , Fountain Street, Ashton-under-Lyne OL6 9RW, Lancashire, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[1999,5,1]]},"reference":[{"key":"2023042616340458000_B1","doi-asserted-by":"crossref","first-page":"1441","DOI":"10.1056\/NEJM197112232852601","article-title":"The natural history of congestive heart failure: the Framingham study","volume":"285","author":"McKee","year":"1971","journal-title":"N Engl J Med"},{"key":"2023042616340458000_B2","doi-asserted-by":"crossref","first-page":"315","DOI":"10.1177\/014107689709000606","article-title":"Renovascular disease: the fifth frontier","volume":"90","author":"Nicholls","year":"1997","journal-title":"J R Soc Med"},{"key":"2023042616340458000_B3","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1056\/NEJM198302173080706","article-title":"Captopril-induced functional renal insufficiency in patients with bilateral renal artery stenoses or renal artery stenosis in a solitary kidney","volume":"308","author":"Hricik","year":"1983","journal-title":"N Engl J Med"},{"key":"2023042616340458000_B4","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1056\/NEJM198610023151402","article-title":"Comparison of captopril and enalapril in patients with severe chronic heart failure","volume":"315","author":"Packer","year":"1986","journal-title":"N Engl J Med"},{"key":"2023042616340458000_B5","doi-asserted-by":"crossref","first-page":"346","DOI":"10.7326\/0003-4819-106-3-346","article-title":"Functional renal insufficiency during long-term therapy with captopril and enalapril in severe chronic heart failure","volume":"106","author":"Packer","year":"1987","journal-title":"Ann Intern Med"},{"key":"2023042616340458000_B6","doi-asserted-by":"crossref","first-page":"434","DOI":"10.1136\/hrt.73.5.434","article-title":"Peripheral haemodynamic effects of inhibition of prostaglandin synthesis in congestive heart failure and interaction with captopril","volume":"73","author":"Townend","year":"1995","journal-title":"Br Heart J"},{"key":"2023042616340458000_B7","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1136\/bmj.308.6924.321","article-title":"Diagnosis and management of heart failure","volume":"308","author":"Dargie","year":"1994","journal-title":"BMJ"},{"key":"2023042616340458000_B8","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/S0002-8703(98)70180-2","article-title":"Is optimal angiotensin-converting enzyme inhibitor dosing neglected in elderly patients with heart failure?","volume":"136","author":"Gattis","year":"1998","journal-title":"Am Heart J"},{"key":"2023042616340458000_B9","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/S0140-6736(97)11060-1","article-title":"Risk of morbidity from renovascular disease in elderly patients with congestive cardiac failure","volume":"352","author":"McDowall","year":"1998","journal-title":"Lancet"}],"container-title":["Postgraduate Medical Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/pmj\/article-pdf\/75\/883\/275\/50046640\/postgradmedj-75-275.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/pmj\/article-pdf\/75\/883\/275\/50046640\/postgradmedj-75-275.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,4,26]],"date-time":"2023-04-26T16:35:42Z","timestamp":1682526942000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/pmj\/article\/75\/883\/275\/7044853"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1999,5,1]]},"references-count":9,"journal-issue":{"issue":"883","published-online":{"date-parts":[[1999,5,1]]},"published-print":{"date-parts":[[1999,5,1]]}},"URL":"https:\/\/doi.org\/10.1136\/pgmj.75.883.275","relation":{},"ISSN":["0032-5473","1469-0756"],"issn-type":[{"value":"0032-5473","type":"print"},{"value":"1469-0756","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[1999,5]]},"published":{"date-parts":[[1999,5,1]]}}}