Target-dose ACE inhibitors in HFrEF: does agent-specific pharmacokinetics matter in advanced CKD?

Kashaf Ikhlas; Ahmad Khubaib Zafar

doi:10.1093/ejhf/xuag252

August 14, 2026European Journal of Heart Failure

Target-dose ACE inhibitors in HFrEF: does agent-specific pharmacokinetics matter in advanced CKD?

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Key result

Target-dose ACE inhibitor pharmacokinetics guide clinical management in patients with HFrEF and advanced CKD.

Key Points

Evaluate whether agent-specific pharmacokinetic properties of ACE inhibitors influence safety and efficacy when titrating to target doses in patients with heart failure with reduced ejection fraction and advanced chronic kidney disease.
Reviewed pharmacokinetic and clearance mechanisms across distinct angiotensin-converting enzyme (ACE) inhibitor agents.
Analyzed clinical implications of drug accumulation and target-dose titration in patients with reduced glomerular filtration rates.
Agent-specific elimination pathways, such as hepatic versus renal clearance, significantly alter drug accumulation profiles in severe renal impairment.
Pharmacokinetic tailoring allows safer optimization toward guideline-directed target doses while minimizing the risk of adverse renal and electrolyte events.

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Implication

Clinical review examines ACE inhibitor pharmacokinetics in heart failure with advanced kidney disease, highlighting the necessity of agent-specific dosing strategies.

Abstract

Kashaf Ikhlas, Ahmad Khubaib Zafar; Target-dose ACE inhibitors in HFrEF: does agent-specific pharmacokinetics matter in advanced CKD?, European Journal of

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Cite This Study

Ikhlas et al. (2026) studied this question. Agent-specific pharmacokinetics of target-dose ACE inhibitors are discussed regarding their clinical relevance in patients with HFrEF and advanced chronic kidney disease.

synapsesocial.com/papers/6a8179dcf2fb91fc834ad499 https://doi.org/10.1093/ejhf/xuag252

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Target-dose ACE inhibitors in HFrEF: does agent-specific pharmacokinetics matter in advanced CKD?

Key Points

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Implication

Abstract

Discussion

Cite This Study

Target-dose ACE inhibitors in HFrEF: does agent-specific pharmacokinetics matter in advanced CKD?

Key Points

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Implication

Abstract

Discussion

Cite This Study

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