Intensified Inhibition of Renin-angiotensin System: a Way to Improve Renal Protection?

Overview

Journal Curr Hypertens Rep

Specialty Cardiology & Vascular Diseases

Date 2009 Mar 13

PMID 19278601

Citations 3

Authors

Paolo Cravedi

Piero Ruggenenti

Giuseppe Remuzzi

Affiliations

Soon will be listed here.

Abstract

Several large, randomized, multicenter studies in diabetic and nondiabetic patients with chronic proteinuric nephropathies have clearly demonstrated that angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARB) are able to reduce urinary protein excretion and retard renal disease progression. However, the number of patients who reach end-stage renal failure is still considerable and there is a great need to identify therapies that can arrest evolution of kidney damage. Maximizing renin-angiotensin system (RAS) blockade through combined ACE inhibitor and ARB therapy has been shown to further increase antiproteinuric and nephroprotective effects of each drug class. However, in order to slow to the greatest extent progression of renal disease, the ideal therapeutic approach for patients with proteinuric nephropathies should be a multimodal strategy including dual RAS blockade, antialdosterone therapy, lipid-lowering agents, smoking cessation, and tight glucose control for diabetes.

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