Dual Renin-Angiotensin-Aldosterone System Inhibition for the Treatment of Diabetic Kidney Disease: Adverse Effects and Unfulfilled Promise

被引：3
作者：
El-Haddad, Boutros [1 ]
Reule, Scott [1 ]
Drawz, Paul E. [1 ]
机构：
[1] Univ Minnesota, Div Renal Dis & Hypertens, Minneapolis, MN 55414 USA
来源：
CURRENT DIABETES REPORTS | 2015年 / 15卷 / 10期
关键词：
Diabetes; Renin; Angiotensin; Aldosterone; Chronic kidney disease; Hypertension; ACE-INHIBITION; NEPHROPATHY; BLOCKADE; MELLITUS; COMBINATION; ACTIVATION; MICROALBUMINURIA; SPIRONOLACTONE; HEMODYNAMICS; TELMISARTAN;
D O I：
10.1007/s11892-015-0640-3
中图分类号：
R5 [内科学];
学科分类号：
1002 ; 100201 ;
摘要：
Diabetic nephropathy (DN) is a major complication of diabetes mellitus (DM) affecting individuals with type 1 or type 2 DM and is the leading cause of chronic kidney disease and end-stage kidney disease (ESKD) in the USA. Estimates of disease burden are projected to increase, with prevalence of nearly one in five adults by 2050. The role of renin-angiotensin-aldosterone system (RAAS) inhibition in delaying the progression of DN utilizing angiotensin-converting enzyme inhibitors or angiotensin receptor blockers has been well established in multiple controlled trials. Given greater reduction of proteinuria with dual RAAS blockade compared to monotherapy alone, the potential benefit of dual therapy on progression of DN has been tested in three large randomized clinical trials. Unfortunately, results from these studies demonstrated lack of benefit of dual blockade on renal or cardiovascular outcomes in patients with diabetes. The overall objectives of this review are to provide both the rationale for dual blockade as potential therapy as well as review the literature of its use in patients with DN.
引用
收藏
页数：6
相关论文
共 42 条
[1]   Current concepts of renal hemodynamics in diabetes [J].
Anderson, S ;
Vora, JP .
JOURNAL OF DIABETES AND ITS COMPLICATIONS, 1995, 9 (04) :304-307
[2]   Improved prognosis of diabetic nephropathy in type 1 diabetes [J].
Andresdottir, Gudbjorg ;
Jensen, Majken L. ;
Carstensen, Bendix ;
Parving, Hans-Henrik ;
Hovind, Peter ;
Hansen, Tine W. ;
Rossing, Peter .
KIDNEY INTERNATIONAL, 2015, 87 (02) :417-426
[3]   Long-term effects of spironolactone on proteinuria and kidney function in patients with chronic kidney disease [J].
Bianchi, S. ;
Bigazzi, R. ;
Campese, V. M. .
KIDNEY INTERNATIONAL, 2006, 70 (12) :2116-2123
[4]   Aldosterone/salt induces renal inflammation and fibrosis in hypertensive rats [J].
Blasi, ER ;
Rocha, R ;
Rudolph, AE ;
Blomme, EAG ;
Polly, ML ;
McMahon, EG .
KIDNEY INTERNATIONAL, 2003, 63 (05) :1791-1800
[5]   DECLINING INCIDENCE OF NEPHROPATHY IN INSULIN-DEPENDENT DIABETES-MELLITUS [J].
BOJESTIG, M ;
ARNQVIST, HJ ;
HERMANSSON, G ;
KARLBERG, BE ;
LUDVIGSSON, J .
NEW ENGLAND JOURNAL OF MEDICINE, 1994, 330 (01) :15-18
[6]   Projection of the year 2050 burden of diabetes in the US adult population: dynamic modeling of incidence, mortality, and prediabetes prevalence [J].
Boyle, James P. ;
Thompson, Theodore J. ;
Gregg, Edward W. ;
Barker, Lawrence E. ;
Williamson, David F. .
POPULATION HEALTH METRICS, 2010, 8
[7]   Angiotensin II type 1-receptor mediated changes in heparan sulfate proteoglycans in human SV40 transformed podocytes [J].
Brinkkoetter, PT ;
Holtgrefe, S ;
Van Der Woude, FJ ;
Yard, BA .
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2004, 15 (01) :33-40
[8]   Additive hypotensive and anti-albuminuric effects of angiotensin-converting enzyme inhibition and angiotensin receptor antagonism in diabetic spontaneously hypertensive rats [J].
Cao, ZM ;
Bonnet, F ;
Davis, B ;
Allen, TJ ;
Cooper, ME .
CLINICAL SCIENCE, 2001, 100 (06) :591-599
[9]   US Renal Data System 2012 Annual Data Report [J].
Collins, Allan J. ;
Foley, Robert N. ;
Herzog, Charles ;
Chavers, Blanche ;
Gilbertson, David ;
Herzog, Charles ;
Ishani, Areef ;
Johansen, Kirsten ;
Kasiske, Bertram ;
Kutner, Nancy ;
Liu, Jiannong ;
St. Peter, Wendy ;
Ding, Shu ;
Guo, Haifeng ;
Kats, Allyson ;
Lamb, Kenneth ;
Li, Shuling ;
Li, Suying ;
Roberts, Tricia ;
Skeans, Melissa ;
Snyder, Jon ;
Solid, Craig ;
Thompson, Bryn ;
Weinhandl, Eric ;
Xiong, Hui ;
Yusef, Akeem ;
Zaun, David ;
Arko, Cheryl ;
Chen, Shu-Cheng ;
Daniels, Frank ;
Ebben, James ;
Frazier, Eric ;
Hanzlik, Christopher ;
Johnson, Roger ;
Sheets, Daniel ;
Wang, Xinyue ;
Forrest, Beth ;
Constantini, Edward ;
Everson, Susan ;
Eggers, Paul ;
Agodoa, Lawrence .
AMERICAN JOURNAL OF KIDNEY DISEASES, 2013, 61 (01) :E1-E459
[10]   MORTALITY OF WORKERS IN 2 MINNESOTA TACONITE MINING AND MILLING OPERATIONS [J].
COOPER, WC ;
WONG, O ;
GRAEBNER, R .
JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL MEDICINE, 1988, 30 (06) :506-511
12345