[Strategies to slow the progression of chronic kidney disease].
High blood pressure and proteinuria are the major factors that drive progression of chronic kidney disease. Target levels for preserving renal function are blood pressure less than 130/80 mmHg and proteinuria less than 0.5 g/day. Angiotensin II converting enzyme inhibitors and sartans should be used as first-line therapy to reach these targets. Their use requires close monitoring of renal function and serum potassium levels. Moderate sodium restriction, possibly combined with diuretic therapy, helps to maximize the effect of renin-angiotensin inhibitors. Patients with chronic kidney disease have a high risk of acute kidney failure, especially due to drugs. All prescriptions must take into account the existence and extent of kidney disease. Patient adhesion and collaboration between health professionals are required if these measures are to be effective in the long term.
Combe
Christian
C
Département de néphrologie, Centre hospitalier universitaire de Bordeaux, Hôpital Pellegrin, Bordeaux. christian.combe@chu-bordeaux.fr
Rigothier
Claire
C
Vendrely
Benoît
B
Chauveau
Philippe
P
Rigalleau
Vincent
V
Lasseur
Catherine
C
D002908:Chronic Disease; D018753:Diet, Protein-Restricted; D004039:Diet, Sodium-Restricted; D018450:Disease Progression; D004232:Diuretics / Q000627:therapeutic use; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D007674:Kidney Diseases / Q000517:prevention & control*; D011507:Proteinuria / Q000517:prevention & control; D016540:Smoking Cessation
D004232:Diuretics