Kidney Armor (Continued)

So you can see how seriously we take ACE inhibitors.

Sadly, patients don't take them as seriously. Just because it's such a good idea that it's the Standard of Care to do it doesn't mean it gets done. When something hurts, everyone wants it fixed. But the apple a day to keep the doctor away isn't something most Americans really buy into any more; and saying "an ACE inhibitor a day to keep the nephrologist at bay" just doesn't roll of the tongue quite as well, anyway.

One of the excuses commonly offered up by folks who don't want to take a medication is fear of side effects. So what are the side effects of ACE inhibitors, you ask? The bad kind, rather than the shield-your-kidney kind? Well, it's true that any armor can chafe. One of the most common side effects (although it only impacts around 10% of people who take it) is a persistent dry cough. If you find yourself coughing inside your protective vest all the time, tell your doc. Generally switching to another ACE will fix the problem.

There is one truly serious side effect associated with ACE inhibitors, and it only applies to the fairer sex, and even then only part of the time. As a class, ACE inhibitors are contraindicated—med-speak for horribly bad and dangerous idea—in pregnancy. They are genuinely toxic to the baby in the 2nd and 3rd trimesters, carrying the ominous "pregnancy category D" from the FDA for the last six months of a pregnancy. There is no doubt that these medications are dangerous to the developing baby.

So, ladies, please put down your kidney shield while you are carrying your baby. Now, while later in the course of a pregnancy the negative side effects are shockingly clear, in the first trimester the effects are less well agreed upon, with some studies even showing them safe. The general practice in the medical trenches is to not withhold ACEs from women of childbearing age, but to pull the plug on them as soon as the pregnancy test shows that happy pair of pink lines.

Of course, you might already be taking an ACE and not even know it. ACEs usually end in "pril." So meds like captopril, enalapril, lisinopril, and ramipril are all ACEs. If you are not on one yet, you should be. They're all generic, so you have no excuses from your wallet not to take one. Four bucks is a cheap bullet-proof vest.

I get that, "Take this pill because you are supposed to," doesn't work for most people. But what if I asked you to put on your bullet-proof vest before you patrolled those gang-infested back alleys at night, zip up your flack vest before going into the war zone, or don your horn-proof stuff before climbing on the back of an angry bull?

Hey, diabetes can be dangerous turf for your kidneys. An ACE inhibitor can help them safe.

And that's no bull.

Learn more about ACE inhibitors:

ACE Inhibitors Reduce Kidney Disease Risk in Diabetics with High Blood Pressure 

Blood Pressure Medications 

Diabetes and Kidney Disease 

Kidney Damage 

One way to protect your kidneys is to be on an ACE inhibitor. Is there a relationship between the dosage you take and the protection it provides?

Pill or Poison?  

Wil Dubois is the author of four multi-award-winning books about diabetes. He is a PWD type 1, and is the diabetes coordinator for a rural non-profit clinic. Visit his blog, LifeAfterDX.

Read Wil's bio here.

Read more of Wil Dubois' columns.

NOTE: The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.

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Last Modified Date: October 10, 2013

All content on is created and reviewed in compliance with our editorial policy.

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by Brenda Bell
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