[Antihypertensive therapy in renal dysfunction].
Antihypertensive treatment is essential to prevention and inhibition of cardiovascular accidents and nephropathy in diabetic patients. Studies have shown that inhibition of the renin-angiotensin system(RAS) exerts beneficial effects beyond its blood pressure-lowing action. In patients with renal dysfunction, RAS inhibition occasionally causes further decline in renal function and hyperkalemia. Because of this, general physicians may hesitate to prescribe RAS inhibitors to patients with renal dysfunction. However, clinical studies have clearly shown that RAS inhibition is particularly beneficial in those patients. This article discusses the conditions associated with RAS inhibition-induced decline in renal function and measures to take against them. In addition, combination therapy with other classes of anti-hypertensives according to renal function and proteinuria is discussed.
Ito
Sadayoshi
S
Division of Nephrology, Endocrinology, and Vascular Medicine, Department of Medicine, Tohoku University School of Medicine.
D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage / Q000009:adverse effects; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D001713:Biphenyl Compounds / Q000008:administration & dosage / Q000009:adverse effects; D002986:Clinical Trials as Topic; D048909:Diabetes Complications; D003928:Diabetic Nephropathies / Q000188:drug therapy* / Q000209:etiology / Q000517:prevention & control; D004359:Drug Therapy, Combination; D006801:Humans; D006947:Hyperkalemia / Q000139:chemically induced; D006973:Hypertension / Q000150:complications / Q000188:drug therapy; D000077405:Irbesartan; D011379:Prognosis; D012084:Renin-Angiotensin System; D013777:Tetrazoles / Q000008:administration & dosage / Q000009:adverse effects
D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D001713:Biphenyl Compounds; D013777:Tetrazoles; D000077405:Irbesartan