What is the most accurate statement regarding vasodilatory agents in patients with chronic kidney disease?

What is the most accurate statement regarding vasodilatory agents in patients with chronic kidney disease?

• A. The pharmacologic half-life of hydralazine is prolonged
• B. Nesiritide is less effective than nitroglycerin
• C. The vasodilatory effects of nitroglycerin are similar on both arterial and venous sides
• D. The most common acid-base disturbance with sodium nitroprusside overuse is metabolic acidosis

Answer: (B)

The statement about nesiritide being less effective than nitroglycerin is accurate because these two agents have different mechanisms and clinical applications. Nesiritide, which is recombinant human B-type natriuretic peptide, primarily acts to promote vasodilation and diuresis, particularly in the setting of heart failure. However, nitroglycerin is often favored in acute scenarios for its rapid action and effectiveness in immediate symptom relief due to its potent vasodilatory effects. This makes nitroglycerin a more commonly used agent, particularly in acute decompensated heart failure or in cases where rapid intervention is necessary. The context of chronic kidney disease (CKD) further affects the use of these agents. In patients with CKD, nitroglycerin is well-documented for its ability to quickly relieve symptoms related to fluid overload, making it a preferred choice over nesiritide in acute situations, therefore supporting the accuracy of the statement regarding the effectiveness comparison between these two agents.

The statement about nesiritide being less effective than nitroglycerin is accurate because these two agents have different mechanisms and clinical applications. Nesiritide, which is recombinant human B-type natriuretic peptide, primarily acts to promote vasodilation and diuresis, particularly in the setting of heart failure. However, nitroglycerin is often favored in acute scenarios for its rapid action and effectiveness in immediate symptom relief due to its potent vasodilatory effects. This makes nitroglycerin a more commonly used agent, particularly in acute decompensated heart failure or in cases where rapid intervention is necessary.

The context of chronic kidney disease (CKD) further affects the use of these agents. In patients with CKD, nitroglycerin is well-documented for its ability to quickly relieve symptoms related to fluid overload, making it a preferred choice over nesiritide in acute situations, therefore supporting the accuracy of the statement regarding the effectiveness comparison between these two agents.