NDT Advance Access originally published online on February 13, 2006
Nephrology Dialysis Transplantation 2006 21(4):846-849; doi:10.1093/ndt/gfl013
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© The Author [2006]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Editorial Comment
Renoprotection of angiotensin receptor blockers: beyond blood pressure lowering
1 Institute of Medical Sciences and Division of Nephrology, Hypertension and Metabolism, Tokai University School of Medicine, Kanagawa, Japan and 2 Service de Nephrologie, Universite Catholique de Louvain, Brussels, Belgium
Correspondence and offprint requests to: Toshio Miyata, MD, PhD, Institute of Medical Sciences and Division of Nephrology, Hypertension and Metabolism, Tokai University School of Medicine, Isehara, Kanagawa 259–1193, Japan. Email: t-miyata@is.icc.u-tokai.ac.jp
Keywords: advanced glycation end products; blood pressure; chronic hypoxia; diabetic nephropathy; oxidative stress; PAI-1; renin-angiotensin system
| The first 150 words of the full text of this article appear below. |
In pioneering studies, Mogensen [1] and Parving et al. [2] have demonstrated that anti-hypertensive treatment slowed the decline of renal function in hypertensive patients with diabetic nephropathy. These observations were subsequently extended to other types of hypertensive renal diseases. No attention was paid to the type of the utilized anti-hypertensive drug: blood pressure lowering was the main goal.
Several clinical studies, mainly but not exclusively in diabetic patients, have subsequently suggested that anti-hypertensive agents inhibiting the renin–angiotensin system (RAS), such as angiotensin converting enzyme inhibitors (ACEIs) or angiotensin II type 1 receptor blockers (ARBs), achieved better renoprotection than other anti-hypertensive drugs [3–7]. Inhibitors of the RAS not only protected renal function, but also lowered proteinuria even at the level of microalbuminuria [6,7]. Microalbuminuria emerged as an important independent risk factor not only for end-stage renal failure but also for cardiovascular
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Renoprotection is partially independent of blood pressure lowering |
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Pleiotropic benefits of ARBs beyond BP lowering |
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Therapeutic perspectives |
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