Nephrol Dial Transplant (2002) 17: 1871-1875
© 2002 European Renal Association-European Dialysis and Transplant Association
Editorial Comments
Halting progression of renal failure: consideration beyond angiotensin II inhibition
Renal Division, Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
Keywords: ACEI; ARB; chronic kidney disease; ESRD; non-renal factors; renal failure progression
| The first 150 words of the full text of this article appear below. |
Over the last decade the number of patients receiving treatment for end-stage renal disease (ESRD) has steadily increased, partly due to an increase in the rate of ESRD incidence [1,2]. An increase in diabetes and poorly controlled hypertension can only partly account for the increase. The role of other risk factors for progressive loss of renal function other than factors directly linked to kidneys may provide additional explanation. That these factors that are seemingly unrelated to the kidneys such as patients' physical characteristics, genetics, environment, race, education, socioeconomic status, drug dependence and health care utilization could have important implication for renal failure progression is not widely appreciated. After a terse remark on the role of angiotensin converting enzyme (ACE) inhibition in renal failure progression, this commentary will focus entirely on non-renal risk factors.
Recent clinical studies have established the therapeutic efficacy of ACE inhibitors (ACEI) and
Familial aggregation of renal disease
ACE genotype
Low-birth weight
Hyperglycaemia and advanced glycosylation end product-related oxidative and carbonyl stress
Hyperlipidaemia
Obesity
High dietary protein intake
Smoking
Socioeconomic status, educational achievement and health care access