[Inhibition of the renin-angiotensin system to prevent target organ damage: the "renal continuum"].
Similar to the atherosclerotic cardiovascular disease, primary and secondary renal diseases are also characterised by a "continuum". The "renal continuum" comprises the initial immunologic, metabolic or hemodynamic insult which, through progressive glomerular and interstitial renal damage, results in end stage renal failure. The rennin-angiotensin system plays a pivotal role in the progression of renal disease. We use diabetic nephropathy to demonstrate the clinical benefits that can be attained by administering inhibitors of the rennin-angiotensin system in more and more progressive stages of the diabetic "renal continuum". Evidence from clinical trials among diabetic patients attest to the notion that specific inhibition of the rennin-angiotensin system provides a benefit that is above what could be expected from the blood pressure lowering effects of these drugs alone.
Tislér
András
A
Semmelweis Egyetem, Altalános Orvostudományi Kar, I. Sz. Belgyógyászati Klinika, Budapest. atisler@axelero.hu
D002318:Cardiovascular Diseases / Q000150:complications / Q000503:physiopathology* / Q000517:prevention & control*; D048909:Diabetes Complications; D018450:Disease Progression; D006801:Humans; D006973:Hypertension / Q000150:complications; D007674:Kidney Diseases / Q000209:etiology / Q000503:physiopathology* / Q000517:prevention & control*; D007676:Kidney Failure, Chronic / Q000517:prevention & control; D012084:Renin-Angiotensin System / Q000187:drug effects / Q000276:immunology; D012307:Risk Factors