title: [Slowing chronic kidney disease progression: hopes and disappointments. Vascular repair of chronic kidney].
abstract: In chronic kidney disease patients, inexorable renal function decline is reduced by renin-angiotensin system (RAS) blockers. ACE inhibitors and angiotensin receptor blockers decrease blood pressure and proteinuria. Guidelines recommend a reduction of blood pressure to less than 130/80 mmHg and urinary protein excretion below 0.5 g/d. The combined use of a diuretic increases anti-proteinuric effect and blood pressure control of RAS blockers. Drugs as mineralo-corticocoids receptor antagonist and endothelin receptor antagonists reduce further albuminuria in combination with RAS blocker, but side effects need to be precised. Both metabolic acidosis and hyperuricemia represent new therapeutic goals to slow renal function decline in CKD patients. Renal fibrosis treatment and regenerative medicine are stemming and will be important issues for kidney and other organs in the future.
authors: Unité Inserm 702, 75020 Paris, France. jean-jacques.boffa@tnn.aphp.fr
authors: Jean-Jacques
authors: JJ
authors: Boffa
authors: Sophie
authors: S
authors: Chauvet
authors: Fabrice
authors: F
authors: Mihout
mesh_terms: D000138:Acidosis / Q000188:drug therapy / Q000503:physiopathology; D000419:Albuminuria / Q000188:drug therapy / Q000503:physiopathology; D047228:Angiotensin II Type 1 Receptor Blockers / Q000009:adverse effects / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D004232:Diuretics / Q000009:adverse effects / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D065128:Endothelin Receptor Antagonists; D005919:Glomerular Filtration Rate / Q000187:drug effects / Q000502:physiology; D006801:Humans; D033461:Hyperuricemia / Q000188:drug therapy / Q000503:physiopathology; D007668:Kidney / Q000098:blood supply*; D007676:Kidney Failure, Chronic / Q000188:drug therapy* / Q000503:physiopathology; D000451:Mineralocorticoid Receptor Antagonists; D011507:Proteinuria / Q000188:drug therapy / Q000503:physiopathology; D017466:Receptors, Endothelin / Q000502:physiology; D018161:Receptors, Mineralocorticoid / Q000502:physiology; D044968:Regenerative Medicine / Q000379:methods; D012084:Renin-Angiotensin System / Q000187:drug effects* / Q000502:physiology
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D004232:Diuretics; D065128:Endothelin Receptor Antagonists; D000451:Mineralocorticoid Receptor Antagonists; D017466:Receptors, Endothelin; D018161:Receptors, Mineralocorticoid