title: Direct renin inhibitor induced renal failure.
abstract: Aliskiren, a direct renin inhibitor, is a novel antihypertensive agent with placebo-like tolerability. The patient developed acute renal failure after addition of aliskiren to combination of diuretic, angiotensin-converting enzyme inhibitor and aldosterone antagonist. This case highlights the point that acute renal failure can occur as an adverse effect of aliskiren. Because there is no conclusive evidence about the safety of aliskiren when used in combination with multiple drugs that inhibit renin angiotensin aldosterone system, caution should be exercised while initiating this drug in patients already on combination of diuretic, angiotensin-converting enzyme inhibitor and aldosterone antagonist.
authors.affiliation: 1Department of Medicine; 2Division of Cardiovascular Diseases, Maimonides Medical Center, Brooklyn, NY.
authors.forename: Ajay
authors.initials: A
authors.lastname: Vallakati
authors.forename: Preeti A
authors.initials: PA
authors.lastname: Chandra
authors.forename: Gerald
authors.initials: G
authors.lastname: Hollander
authors.forename: Jacob
authors.initials: J
authors.lastname: Shani
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced*; D000368:Aged; D000577:Amides / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D004232:Diuretics / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D005650:Fumarates / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D008297:Male; D000451:Mineralocorticoid Receptor Antagonists / Q000008:administration & dosage; D000092502:Renin Inhibitors
chemical_list: D000577:Amides; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D004232:Diuretics; D005650:Fumarates; D000451:Mineralocorticoid Receptor Antagonists; D000092502:Renin Inhibitors; C446481:aliskiren