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NDT Advance Access originally published online on May 8, 2008
Nephrology Dialysis Transplantation 2008 23(8):2443-2447; doi:10.1093/ndt/gfn239
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Maximizing inhibition of the renin–angiotensin system with high doses of converting enzyme inhibitors or angiotensin receptor blockers

Tomas Berl

Division of Nephrology, University of Colorado Health Sciences, Denver, CO 80262, USA

Correspondence and offprint requests to: Tomas Berl, Division of Nephrology, University of Colorado Health Sciences, 4200 East Ninth Avenue, Box C281, Biomedical Research Building, Room 423, Denver, CO 80262, USA. Tel: +1-303-315-7204; Fax: +1- 303-315-0189; E-mail: Tomas.Berl@uchsc.edu

The first 150 words of the full text of this article appear below.

Over the last 20 years, inhibitors of the renin–angiotensin–aldosterone system (RAAS) have become the cornerstone in the treatment of hypertension. Likewise, these drugs have found an increasing use in patients with underlying renal disease, as numerous lines of evidence have pointed to their having a blood pressure lowering independent antiproteinuric effect [1]. This effect of renin–angiotensin system (RAS) inhibitors gains in significance as several large interventional studies have uniformly found that proteinuria is a major risk factor for progression of renal disease [2–5]. In fact, in some of these studies [3,4] the reduction of proteinuria in patients with diabetic nephropathy was associated with a decreased risk of reaching a renal endpoint which included doubling of serum creatinine and end-stage renal disease (ESRD). A similar observation has been made in non-diabetic kidney disease with lower levels of baseline proteinuria [5], demonstrating the importance . . . [Full Text of this Article]



   Studies with high doses of ACE inhibitors (Table 2)
 


   Studies with high doses of ARBs (Table 3)
 


   Dosing and RAS blockade
 


   Safety considerations
 


   Summary and conclusions
 

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High-dose angiotensin-converting enzyme inhibitor attenuates oxidative stress in patients with chronic kidney disease
Nephrol. Dial. Transplant., February 1, 2009; 24(2): 689 - 690.
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