Document Detail


Dual effects of RAS blockade on blood pressure and podocyte function.
MedLine Citation:
PMID:  18177588     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
There is no question about the contributory risk of hypertension in morbidity and mortality from cardiovascular (CV) disease and chronic kidney disease (CKD). Another independent risk factor for CV disease and CKD is proteinuria, which is most commonly caused by dysfunction of the kidney glomerular filter, in particular of the podocyte. Podocytes are highly differentiated pericyte-like cells that are essential to normal kidney function. Moreover, loss of podocytes is a hallmark of diabetic and nondiabetic progressive CKD. Recent data point to an important role for the renin-angiotensin system (RAS) and calcium signaling in the structural and functional integrity of podocytes. Given this scenario, it is desirable to treat hypertension with agents targeting the RAS, such as angiotensin-converting enzyme (ACE) inhibitors and angiotensin II (Ang II) type 1-receptor blockers (ARB). These agents have proven effects on lowering blood pressure (BP) and can reduce podocyte injury. Here we review the dual effects of RAS blockade on BP and on podocyte function and emphasize BP-dependent and BP-independent effects of this regimen.
Authors:
Jochen Reiser; Peter Mundel
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Current hypertension reports     Volume:  9     ISSN:  1522-6417     ISO Abbreviation:  Curr. Hypertens. Rep.     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2008-01-07     Completed Date:  2008-02-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100888982     Medline TA:  Curr Hypertens Rep     Country:  United States    
Other Details:
Languages:  eng     Pagination:  403-8     Citation Subset:  IM    
Affiliation:
Division of Nephrology, Program in Glomerular Disease, Massachusetts General Hospital and Harvard Medical School, CNY-149, 13th Street, Suite 8214, Boston, MA 02129, USA. jreiser@partners.org
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MeSH Terms
Descriptor/Qualifier:
Angiotensin II Type 1 Receptor Blockers / pharmacology*
Angiotensin-Converting Enzyme Inhibitors / pharmacology*
Blood Pressure / drug effects
Diabetic Nephropathies / prevention & control
Humans
Hypertension / drug therapy*
Kidney Failure, Chronic / prevention & control
Podocytes / drug effects*
Renin-Angiotensin System / drug effects*
Grant Support
ID/Acronym/Agency:
DA18886/DA/NIDA NIH HHS; DK062472/DK/NIDDK NIH HHS; DK064236/DK/NIDDK NIH HHS; DK073495/DK/NIDDK NIH HHS; DK57683/DK/NIDDK NIH HHS
Chemical
Reg. No./Substance:
0/Angiotensin II Type 1 Receptor Blockers; 0/Angiotensin-Converting Enzyme Inhibitors

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


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