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Renal protective effects of the renin-angiotensin-aldosterone system blockade: from evidence-based approach to perspectives.
Kidney Blood Press Res. 2005; 28(4):230-42.KB

Abstract

The renin-angiotensin-aldosterone system (RAAS) blockade is currently the best-documented treatment strategy to delay the progression of chronic nephropathies. Angiotensin-converting enzyme inhibitors (CEIs) or angiotensin II type 1 receptor antagonists (ARBs) should be used in every normotensive and hypertensive patient with chronic proteinuric nephropathy of both diabetic and non-diabetic origin. The therapy should be initiated as early as possible, bearing in mind that the renoprotection is more effective if used before overt proteinuria or a reduction in kidney function is present. The therapy should be offered to all patients, regardless of renal function, as well as to subjects with severely impaired glomerular filtration. CEIs and ARBs should be administered in therapeutic doses as high as possible to achieve maximal possible proteinuria reduction and systemic blood pressure target <130/80 mm Hg, and 125/75 mm Hg in those subjects with renal insufficiency who present with proteinuria above 1 g/24 h. The combined therapy with the concomitant use of CEIs and ARBs should be offered to all patients with proteinuric non-diabetic chronic nephropathies who do not achieve full and persistent remission of proteinuria with CEI or ARB alone. The article reviews an evidence-based approach on the use of RAAS-inhibiting agents in kidney diseases, considers treatment strategies in different clinical situations and discusses some perspectives related to the implementation of the RAAS blockade in renal protection.

Authors+Show Affiliations

Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, Poland. leszek.tylicki@amg.gda.plNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

16127280

Citation

Tylicki, Leszek, et al. "Renal Protective Effects of the Renin-angiotensin-aldosterone System Blockade: From Evidence-based Approach to Perspectives." Kidney & Blood Pressure Research, vol. 28, no. 4, 2005, pp. 230-42.
Tylicki L, Larczynski W, Rutkowski B. Renal protective effects of the renin-angiotensin-aldosterone system blockade: from evidence-based approach to perspectives. Kidney Blood Press Res. 2005;28(4):230-42.
Tylicki, L., Larczynski, W., & Rutkowski, B. (2005). Renal protective effects of the renin-angiotensin-aldosterone system blockade: from evidence-based approach to perspectives. Kidney & Blood Pressure Research, 28(4), 230-42.
Tylicki L, Larczynski W, Rutkowski B. Renal Protective Effects of the Renin-angiotensin-aldosterone System Blockade: From Evidence-based Approach to Perspectives. Kidney Blood Press Res. 2005;28(4):230-42. PubMed PMID: 16127280.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Renal protective effects of the renin-angiotensin-aldosterone system blockade: from evidence-based approach to perspectives. AU - Tylicki,Leszek, AU - Larczynski,Wojciech, AU - Rutkowski,Bolesław, Y1 - 2005/08/25/ PY - 2005/8/30/pubmed PY - 2006/2/7/medline PY - 2005/8/30/entrez SP - 230 EP - 42 JF - Kidney & blood pressure research JO - Kidney Blood Press Res VL - 28 IS - 4 N2 - The renin-angiotensin-aldosterone system (RAAS) blockade is currently the best-documented treatment strategy to delay the progression of chronic nephropathies. Angiotensin-converting enzyme inhibitors (CEIs) or angiotensin II type 1 receptor antagonists (ARBs) should be used in every normotensive and hypertensive patient with chronic proteinuric nephropathy of both diabetic and non-diabetic origin. The therapy should be initiated as early as possible, bearing in mind that the renoprotection is more effective if used before overt proteinuria or a reduction in kidney function is present. The therapy should be offered to all patients, regardless of renal function, as well as to subjects with severely impaired glomerular filtration. CEIs and ARBs should be administered in therapeutic doses as high as possible to achieve maximal possible proteinuria reduction and systemic blood pressure target <130/80 mm Hg, and 125/75 mm Hg in those subjects with renal insufficiency who present with proteinuria above 1 g/24 h. The combined therapy with the concomitant use of CEIs and ARBs should be offered to all patients with proteinuric non-diabetic chronic nephropathies who do not achieve full and persistent remission of proteinuria with CEI or ARB alone. The article reviews an evidence-based approach on the use of RAAS-inhibiting agents in kidney diseases, considers treatment strategies in different clinical situations and discusses some perspectives related to the implementation of the RAAS blockade in renal protection. SN - 1420-4096 UR - https://www.unboundmedicine.com/medline/citation/16127280/Renal_protective_effects_of_the_renin_angiotensin_aldosterone_system_blockade:_from_evidence_based_approach_to_perspectives_ L2 - https://www.karger.com?DOI=10.1159/000087842 DB - PRIME DP - Unbound Medicine ER -