Therapeutic strategies to slow chronic kidney disease progression

被引：0
作者：
Elke Wühl
Franz Schaefer
机构：
[1] University Hospital Heidelberg for Pediatric and Adolescent Medicine,Division of Pediatric Nephrology
来源：
Pediatric Nephrology | 2008年 / 23卷
关键词：
Chronic kidney disease; Progression; Children; Prevention; Hypertension; Proteinuria;
D O I：
暂无
中图分类号：
学科分类号：
摘要：
Childhood chronic kidney disease commonly progresses toward end-stage renal failure, largely independent of the underlying disorder, once a critical impairment of renal function has occurred. Hypertension and proteinuria are the most important independent risk factors for renal disease progression. Therefore, current therapeutic strategies to prevent progression aim at controlling blood pressure and reducing urinary protein excretion. Renin-angiotensin-system (RAS) antagonists preserve kidney function not only by lowering blood pressure but also by their antiproteinuric, antifibrotic, and anti-inflammatory properties. Intensified blood pressure control, probably aiming for a target blood pressure below the 75th percentile, may exert additional renoprotective effects. Other factors contributing in a multifactorial manner to renal disease progression include dyslipidemia, anemia, and disorders of mineral metabolism. Measures to preserve renal function should therefore also comprise the maintenance of hemoglobin, serum lipid, and calcium-phosphorus ion product levels in the normal range.
引用
收藏
页码：705 / 716
页数：11
相关论文
共 626 条
  • [1] Ardissino G(2003)Epidemiology of chronic renal failure in children: data from the ItalKid Project Pediatrics 111 382-387
  • [2] Dacco V(2007)Progression of chronic renal failure in children with dysplastic kidneys Pediatr Nephrol 7 1014-20
  • [3] Testa S(1996)Blood pressure and end-stage renal disease in men Hypertension 13 180-193
  • [4] Bonaudo R(2003)Proteinuria and the risk of developing end-stage renal disease Kidney Int 63 1468-1474
  • [5] Claris-Appiani A(1996)Proteinuria and blood pressure as causal components of progression to end-stage renal failure. Northern Italian Cooperative Study Group Nephrol Dial Transplant 11 461-467
  • [6] Taioli E(2006)Control of hypertension in children after renal transplantation Pediatr Transplant 10 316-322
  • [7] Marra G(1997)Twenty-four-hour ambulatory blood pressure profiles in pediatric patients after renal transplantation Pediatr Nephrol 11 23-26
  • [8] Edefonti A(1997)Randomised multicentre study of a low-protein diet on the progression of chronic renal failure in children. European study group of nutritional treatment of chronic renal failure in childhood Lancet 349 1117-1123
  • [9] Sereni F(2000)Preserving renal function in adults with hypertension and diabetes: a consensus approach. National kidney foundation hypertension and diabetes executive committees working group Am J Kidney Dis 36 646-661
  • [10] González Celedón C(1995)Blood pressure control, proteinuria, and the progression of renal disease. The modification of diet in renal disease study Ann Intern Med 123 754-762
12345678910