ACEi vs ARB in Scleroderma with renal crisis

雖然它們都跟RAS inhibition有關 ACEi 與ARB終究還是屬於不同的東西 Scleroderma with renal involvement (SSc)，
short-acting ACEi 還是優先於ARB 的使用，
當ACEi 的額度用滿了，ARB還可以考慮作為add-on
( by Harrison, 19/e; Washington, 35/e; and Brenner, 10/e)
BUT，遇到了Scleroderma with vascular involvement的時候，
ARB卻比起ACEi 來得有效（effective）（by Harrison, 19/e) 結論就是說當遇到了systemic sclerosis with renal crisis時，
要記得給short-acting ACEi 雖然文獻不多，
Brenner仍然舉了二篇case report來說明ACEi is better than ARB in scleroderma with renal crisis. 2005 AJKD--Late Recurrence of Scleroderma Renal Crisis in a Renal Transplant Recipient Despite Angiotensin II Blockade
1997 Lancet--Failure of losartan to control blood pressure in scleroderma renal crisis