Tags

Type your tag names separated by a space and hit enter

Prevention of progression of nephropathy.
Nephrol Dial Transplant. 1997; 12 Suppl 2:63-6.ND

Abstract

Several factors have been implicated in progressive nephropathy. In a recent clinical trial, the Modification of Diet in Renal Disease (MDRD) study, six factors out of 41 examined were found to be predictors of progression of renal disease: proteinuria, mean arterial pressure, black race, diagnosis of polycystic kidney disease, serum transferin levels, and serum high density lipoprotein (HDL) cholesterol. Hypertension as a factor in progressive renal disease has been documented in both animal and human studies. Patients in the MDRD study were randomly assigned to two levels of blood pressure control: usual (mean arterial pressure of 107 mmHg) or low (mean arterial pressure of 92 mmHg). Patients with proteinuria > 1 g/day assigned to the low blood pressure goal had a slower mean decline in GFR as compared to patients assigned to the usual blood pressure goal. Recommendations derived from the results of the MDRD study specify that in patients with proteinuria > 1 g/day, a mean arterial pressure goal of 92 mmHg or less (equivalent to a blood pressure of 125/75 mmHg) should be the target. Several studies have suggested that dietary protein restriction benefits patients with chronic renal disease. The MDRD study found that dietary protein restriction slowed disease progression in patients with more advanced renal disease (GFR 13-24 ml/min) at the onset of the trial. In summary, current evidence indicates that a decrease in proteinuria, lowering of systemic blood pressure, and a decreased intake of protein ameliorate the rate of progression (loss of GFR) in patients with chronic renal disease.

Authors+Show Affiliations

Department of Internal Medicine, Washington University School of Medicine, St Louis, MO, USA.

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial
Review

Language

eng

PubMed ID

9269703

Citation

Klahr, S. "Prevention of Progression of Nephropathy." Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, vol. 12 Suppl 2, 1997, pp. 63-6.
Klahr S. Prevention of progression of nephropathy. Nephrol Dial Transplant. 1997;12 Suppl 2:63-6.
Klahr, S. (1997). Prevention of progression of nephropathy. Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association, 12 Suppl 2, 63-6.
Klahr S. Prevention of Progression of Nephropathy. Nephrol Dial Transplant. 1997;12 Suppl 2:63-6. PubMed PMID: 9269703.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prevention of progression of nephropathy. A1 - Klahr,S, PY - 1997/1/1/pubmed PY - 1997/1/1/medline PY - 1997/1/1/entrez SP - 63 EP - 6 JF - Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association JO - Nephrol Dial Transplant VL - 12 Suppl 2 N2 - Several factors have been implicated in progressive nephropathy. In a recent clinical trial, the Modification of Diet in Renal Disease (MDRD) study, six factors out of 41 examined were found to be predictors of progression of renal disease: proteinuria, mean arterial pressure, black race, diagnosis of polycystic kidney disease, serum transferin levels, and serum high density lipoprotein (HDL) cholesterol. Hypertension as a factor in progressive renal disease has been documented in both animal and human studies. Patients in the MDRD study were randomly assigned to two levels of blood pressure control: usual (mean arterial pressure of 107 mmHg) or low (mean arterial pressure of 92 mmHg). Patients with proteinuria > 1 g/day assigned to the low blood pressure goal had a slower mean decline in GFR as compared to patients assigned to the usual blood pressure goal. Recommendations derived from the results of the MDRD study specify that in patients with proteinuria > 1 g/day, a mean arterial pressure goal of 92 mmHg or less (equivalent to a blood pressure of 125/75 mmHg) should be the target. Several studies have suggested that dietary protein restriction benefits patients with chronic renal disease. The MDRD study found that dietary protein restriction slowed disease progression in patients with more advanced renal disease (GFR 13-24 ml/min) at the onset of the trial. In summary, current evidence indicates that a decrease in proteinuria, lowering of systemic blood pressure, and a decreased intake of protein ameliorate the rate of progression (loss of GFR) in patients with chronic renal disease. SN - 0931-0509 UR - https://www.unboundmedicine.com/medline/citation/9269703/Prevention_of_progression_of_nephropathy_ L2 - https://medlineplus.gov/kidneydiseases.html DB - PRIME DP - Unbound Medicine ER -