Clinical trials of the past decade in the management of chronic kidney disease.
The three main causes of Chronic Kidney Diseases [CKD] are diabetes mellitus, chronic glomerulonephritis and hypertension. CKD is an increasing burden in the community as more patients fall prey to kidney failure. Both dialysis and renal transplantation are expensive modalities of treatment for end stage renal failure [ESRF]. Through the years many clinical trials have been performed to retard the progression of CKD to ESRF. Most of the trials focus on three main strategies which aim at renal retardation, namely, control of hypertension, treatment of proteinuria and control of hypercholesterolaemia. More recently, investigators have been exploring the role of high dose ARBs as well as the use of Aliskiren, a renin inhibitor. Early therapeutic intervention is necessary as it will contribute to better chances of minimising glomerular damage and in the case of some, even lead to the improvement of renal function with regression of glomerulosclerosis.
Woo
Keng-Thye
KT
Department of Renal Medicine, Singapore General Hospital, Outram Road, Singapore 169608, Singapore. woo.keng.thye@sgh.com.sg
Wong
Kok-Seng
KS
Chan
Choong-Meng
CM
D000577:Amides / Q000627:therapeutic use; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D005650:Fumarates / Q000627:therapeutic use; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications / Q000517:prevention & control; D006973:Hypertension / Q000150:complications / Q000517:prevention & control; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000628:therapy*; D019808:Losartan / Q000627:therapeutic use; D011507:Proteinuria / Q000150:complications / Q000517:prevention & control; D017582:Renal Replacement Therapy / Q000379:methods
D000577:Amides; D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D005650:Fumarates; C446481:aliskiren; D019808:Losartan