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Why is the renal function continuing to decline on ACEI/ARB despite no reno-vascular disease on Doppler scan?

April 26, 2017acei ARB Continuing decline disease Doppler function renal reno-vascular

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Why is the renal function continuing to decline on ACEI/ARB despite no reno-vascular disease on Doppler scan?

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The patient most likely has small vessel disease that is not amenable to angioplasty or stenting and if the renal function continues to decline then unfortunately the ACEI/ARB will have to be stopped and alternatives used.