ACE inhibitors are contraindicated in: March 2007

Ans. C: Renal Aery Stenosis Renal aery stenosis is the narrowing of the renal aery, most often caused by atherosclerosis or fibromuscular dysplasia, impeding the blood flow to the target kidney. Diagnosis of renal aery stenosis: Refractory hypeension - high blood pressure that cannot be controlled adequately with antihypeensives Auscultation reveals a bruit ("rushing" sound) on affected side, inferior of the costal margin Captopril challenge test Captopril test dose effect on the differential renal function as measured by MAG3 scan. Renal aery aeriogram Deterioration in renal function may develop if both kidneys are poorly supplied, or when treatment with an ACE inhibitor is initiated. Hence ACE inhibitors are contraindicated in renal aery stenosis.