Renin-Angiotensin-Aldosterone System Blockade in Diabetic Nephropathy. Present Evidences

Journal of Clinical Medicine

Luz Lozano-Maneiro¹  Adriana Puente-García²  Juan F. Navarro-González² 

[1] Division of Nephrology, Department of Internal Medicine, Fuenlabrada University Hospital, Rey Juan Carlos University School of Medicine, Camino del Molino, 2, 28942 Fuenlabrada, Madrid, Spain; E-Mail

关键词: renin-angiotensin-aldosterone system blockade;    combined RAAS blockade;    dual RAAS blockade;    diabetic nephropathy;    diabetic kidney disease;    ACE inhibitors;    angiotensin receptor blockers;    direct renin inhibitors;    mineralocorticoid receptor antagonists;    aldosterone antagonist;   

DOI  :  10.3390/jcm4111908

来源: mdpi

【 摘 要 】

Diabetic Kidney Disease (DKD) is the leading cause of chronic kidney disease in developed countries and its prevalence has increased dramatically in the past few decades. These patients are at an increased risk for premature death, cardiovascular disease, and other severe illnesses that result in frequent hospitalizations and increased health-care utilization. Although much progress has been made in slowing the progression of diabetic nephropathy, renal dysfunction and the development of end-stage renal disease remain major concerns in diabetes. Dysregulation of the renin-angiotensin-aldosterone system (RAAS) results in progressive renal damage. RAAS blockade is the cornerstone of treatment of DKD, with proven efficacy in many arenas. The theoretically-attractive option of combining these medications that target different points in the pathway, potentially offering a more complete RAAS blockade, has also been tested in clinical trials, but long-term outcomes were disappointing. This review examines the “state of play” for RAAS blockade in DKD, dual blockade of various combinations, and a perspective on its benefits and potential risks.

【 授权许可】

CC BY   
© 2015 by the authors; licensee MDPI, Basel, Switzerland.