Slowing Nephropathy Progression: Focus on Proteinuria Reduction

Overview

Journal Clin J Am Soc Nephrol

Specialty Nephrology

Date 2008 Feb 7

PMID 18178794

Citations 52

Authors

George L Bakris

Affiliations

Soon will be listed here.

Abstract

Blood pressure control reduces decline of kidney function. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers offer renoprotection to a small extent beyond that attributable to blood pressure lowering. These agents also reduce proteinuria, a risk marker for renal disease progression. Accumulating evidence indicates that their antiproteinuric effect correlates with their additional renal benefits.

Citing Articles

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Long-Term Impact of Renin-Angiotensin System Inhibitors for Secondary Prevention in Patients with Chronic Kidney Disease Who Underwent Percutaneous Coronary Intervention.

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Changes in proteinuria and the associated risks of ischemic heart disease, acute myocardial infarction, and angina pectoris in Korean population.

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References

Brenner B, Cooper M, de Zeeuw D, Keane W, Mitch W, Parving H . Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy. N Engl J Med. 2001; 345(12):861-9. DOI: 10.1056/NEJMoa011161. View

Lewis E, Hunsicker L, Clarke W, Berl T, Pohl M, Lewis J . Renoprotective effect of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes. N Engl J Med. 2001; 345(12):851-60. DOI: 10.1056/NEJMoa011303. View

Bakris G, Weir M . ACE inhibitors and protection against kidney disease progression in patients with type 2 diabetes: what's the evidence. J Clin Hypertens (Greenwich). 2002; 4(6):420-3. PMC: 8101879. DOI: 10.1111/j.1524-6175.2002.01641.x. View

Nakao N, Yoshimura A, Morita H, Takada M, Kayano T, Ideura T . Combination treatment of angiotensin-II receptor blocker and angiotensin-converting-enzyme inhibitor in non-diabetic renal disease (COOPERATE): a randomised controlled trial. Lancet. 2003; 361(9352):117-24. DOI: 10.1016/S0140-6736(03)12229-5. View

Yuyun M, Dinneen S, Edwards O, Wood E, Wareham N . Absolute level and rate of change of albuminuria over 1 year independently predict mortality and cardiovascular events in patients with diabetic nephropathy. Diabet Med. 2003; 20(4):277-82. DOI: 10.1046/j.1464-5491.2003.00940.x. View

Kramer H, Nguyen Q, Curhan G, Hsu C . Renal insufficiency in the absence of albuminuria and retinopathy among adults with type 2 diabetes mellitus. JAMA. 2003; 289(24):3273-7. DOI: 10.1001/jama.289.24.3273. View

Chua D, Bakris G . Is proteinuria a plausible target of therapy?. Curr Hypertens Rep. 2004; 6(3):177-81. DOI: 10.1007/s11906-004-0066-9. View

de Zeeuw D, Remuzzi G, Parving H, Keane W, Zhang Z, Shahinfar S . Proteinuria, a target for renoprotection in patients with type 2 diabetic nephropathy: lessons from RENAAL. Kidney Int. 2004; 65(6):2309-20. DOI: 10.1111/j.1523-1755.2004.00653.x. View

Teo K, Yusuf S, Sleight P, Anderson C, Mookadam F, Ramos B . Rationale, design, and baseline characteristics of 2 large, simple, randomized trials evaluating telmisartan, ramipril, and their combination in high-risk patients: the Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint.... Am Heart J. 2004; 148(1):52-61. DOI: 10.1016/j.ahj.2004.03.020. View

10.

de Zeeuw D, Remuzzi G, Parving H, Keane W, Zhang Z, Shahinfar S . Albuminuria, a therapeutic target for cardiovascular protection in type 2 diabetic patients with nephropathy. Circulation. 2004; 110(8):921-7. DOI: 10.1161/01.CIR.0000139860.33974.28. View

11.

Mann J, Yi Q, Gerstein H . Albuminuria as a predictor of cardiovascular and renal outcomes in people with known atherosclerotic cardiovascular disease. Kidney Int Suppl. 2004; (92):S59-62. DOI: 10.1111/j.1523-1755.2004.09215.x. View

12.

Hebert L, Bain R, Verme D, Cattran D, Whittier F, Tolchin N . Remission of nephrotic range proteinuria in type I diabetes. Collaborative Study Group. Kidney Int. 1994; 46(6):1688-93. DOI: 10.1038/ki.1994.469. View

13.

Maschio G, Alberti D, Janin G, Locatelli F, Mann J, Motolese M . Effect of the angiotensin-converting-enzyme inhibitor benazepril on the progression of chronic renal insufficiency. The Angiotensin-Converting-Enzyme Inhibition in Progressive Renal Insufficiency Study Group. N Engl J Med. 1996; 334(15):939-45. DOI: 10.1056/NEJM199604113341502. View

14.

Peterson J, Adler S, Burkart J, Greene T, Hebert L, Hunsicker L . Blood pressure control, proteinuria, and the progression of renal disease. The Modification of Diet in Renal Disease Study. Ann Intern Med. 1995; 123(10):754-62. DOI: 10.7326/0003-4819-123-10-199511150-00003. View

15.

. Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. UK Prospective Diabetes Study Group. BMJ. 1998; 317(7160):703-13. PMC: 28659. View

16.

Ruggenenti P, Perna A, Gherardi G, Gaspari F, Benini R, Remuzzi G . Renal function and requirement for dialysis in chronic nephropathy patients on long-term ramipril: REIN follow-up trial. Gruppo Italiano di Studi Epidemiologici in Nefrologia (GISEN). Ramipril Efficacy in Nephropathy. Lancet. 1998; 352(9136):1252-6. DOI: 10.1016/s0140-6736(98)04433-x. View

17.

Estacio R, Schrier R . Antihypertensive therapy in type 2 diabetes: implications of the appropriate blood pressure control in diabetes (ABCD) trial. Am J Cardiol. 1998; 82(9B):9R-14R. DOI: 10.1016/s0002-9149(98)00750-4. View

18.

Ruggenenti P, Perna A, Gherardi G, Garini G, Zoccali C, Salvadori M . Renoprotective properties of ACE-inhibition in non-diabetic nephropathies with non-nephrotic proteinuria. Lancet. 1999; 354(9176):359-64. DOI: 10.1016/S0140-6736(98)10363-X. View

19.

Barnett A, Bain S, Bouter P, Karlberg B, Madsbad S, Jervell J . Angiotensin-receptor blockade versus converting-enzyme inhibition in type 2 diabetes and nephropathy. N Engl J Med. 2004; 351(19):1952-61. DOI: 10.1056/NEJMoa042274. View

20.

Atkins R, Briganti E, Lewis J, Hunsicker L, Braden G, Champion de Crespigny P . Proteinuria reduction and progression to renal failure in patients with type 2 diabetes mellitus and overt nephropathy. Am J Kidney Dis. 2005; 45(2):281-7. DOI: 10.1053/j.ajkd.2004.10.019. View