Document Detail


Inhibition of the renin-angiotensin system and chronic kidney disease.
MedLine Citation:
PMID:  18704745     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Chronic kidney disease (CKD), a major worldwide public-health problem which affects about 10% of the population, has an increased annual incidence rate of about 5-8%. This increased incidence is mainly due to type 2 diabetes and hypertension and the increasing incidence of elderly patients with CKD. Although the progression to end-stage renal failure (ESRF) is mainly based upon the underlying disease, comorbid conditions such as an initial low renal function, severe proteinuria, and high levels of blood pressure also play important roles in the development of ESRF. Since experimental and clinical evidence suggest that angiotensin II plays a central role in the progression of CKD, pharmacological inhibition of the renin-angiotensin-aldosteron system (RAAS) with angiotensin converting enzyme inhibitors or angiotensin II receptor antagonists has been suggested as first-line treatment for hypertension and prevention of ESRF in these patients. Aliskiren, a novel renin inhibitor is also a promising medical intervention. However, independently of the category of the drugs used, low target blood pressure levels seem to be equally or more important for the delay or prevention of CKD. In this review the results of studies with pharmacological inhibition of the RAAS in patients with diabetic and nondiabetic nephropathy is discussed.
Authors:
Kostas C Siamopoulos; Rigas G Kalaitzidis
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Publication Detail:
Type:  Journal Article; Review     Date:  2008-08-14
Journal Detail:
Title:  International urology and nephrology     Volume:  40     ISSN:  0301-1623     ISO Abbreviation:  Int Urol Nephrol     Publication Date:  2008  
Date Detail:
Created Date:  2008-11-07     Completed Date:  2009-03-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0262521     Medline TA:  Int Urol Nephrol     Country:  Hungary    
Other Details:
Languages:  eng     Pagination:  1015-25     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Medical School, University of Ioannina, 451 10, Ioannina, Greece. ksiamop@cc.uoi.gr
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MeSH Terms
Descriptor/Qualifier:
Angiotensin II Type 1 Receptor Blockers / adverse effects,  pharmacology*
Angiotensin-Converting Enzyme Inhibitors / adverse effects,  pharmacology*
Clinical Trials as Topic
Drug Therapy, Combination
Humans
Kidney Failure, Chronic / complications,  drug therapy*,  physiopathology
Renin-Angiotensin System / drug effects*
Chemical
Reg. No./Substance:
0/Angiotensin II Type 1 Receptor Blockers; 0/Angiotensin-Converting Enzyme Inhibitors
Comments/Corrections
Comment In:
Int Urol Nephrol. 2008;40(4):1115-6   [PMID:  18807206 ]

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