Document Detail


Aldosterone and progression of renal disease.
MedLine Citation:
PMID:  18090669     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE OF REVIEW: The aim of this review is to look at the role of aldosterone in the progression of chronic kidney disease. The reduction of blood pressure and proteinuria in patients suffering from chronic kidney disease decreases the rate of disease progression. Suppression of angiotensin formation by angiotensin converting enzyme inhibitors and blockade of the angiotensin II receptor by angiotensin II type 1 antagonists are powerful therapeutic strategies that effectively lower blood pressure and slow the progression of renal disease. These therapies, however, provide only imperfect protection, since they cannot always prevent endstage renal failure. RECENT FINDINGS: Aldosterone plays a significant role in the pathogenesis of arterial hypertension and renal disease. Angiotensin converting enzyme inhibitors and angiotensin II type 1 antagonists are incomplete in suppressing aldosterone production and 'aldosterone breakthrough' can be observed under continued treatment. Aldosterone blockade reduces blood pressure in virtually all patients with hypertension. In proteinuric patients, the addition of an aldosterone antagonist to an angiotensin converting enzyme inhibitor or to angiotensin II type 1 antagonists reduces proteinuria. SUMMARY: The use of aldosterone antagonists in addition to either angiotensin converting enzyme inhibitors or angiotensin II type 1 antagonists in proteinuric patients reduces proteinuria, which may translate into preservation of the glomerular filtration rate in the longer term. Therefore, blockade of the aldosterone pathway may prove to be a beneficial therapy for chronic kidney disease.
Authors:
Ulrich Wenzel
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Current opinion in nephrology and hypertension     Volume:  17     ISSN:  1062-4821     ISO Abbreviation:  Curr. Opin. Nephrol. Hypertens.     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2007-12-19     Completed Date:  2008-02-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9303753     Medline TA:  Curr Opin Nephrol Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  44-50     Citation Subset:  IM    
Affiliation:
Department of Medicine, Division of Nephrology, University Hospital of Hamburg, Hamburg, Germany. wenzel@uke.uni-hamburg.de
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MeSH Terms
Descriptor/Qualifier:
Aldosterone / metabolism*
Animals
Disease Progression
Humans
Hypertension / metabolism,  pathology
Kidney Diseases / metabolism,  pathology*
Proteinuria / metabolism,  pathology
Receptors, Cell Surface / metabolism
Chemical
Reg. No./Substance:
0/Receptors, Cell Surface; 0/prorenin receptor; 52-39-1/Aldosterone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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