title: RAAS inhibition and renal protection.
abstract: Chronic kidney disease has become a major public health problem worldwide mainly as a consequence of the emerging epidemic of hypertension, diabetes, and obesity. It is currently estimated that nearly 15% of the general population has some degree of renal damage, a figure that reaches 50% in at-risk subgroups. Renin-angiotensin-aldosterone system (RAAS) inhibitors represent the agents of choice to control hypertension and reduce urinary albumin excretion, thereby delaying renal function deterioration. Greater blockade of the RAAS either by the combined use of multiple drugs or by supramaximal doses of single agents may provide greater renal protection. Furthermore, it has been proposed especially in the presence of proteinuria. However, at this time there is insufficient evidence to routinely recommend this therapeutic approach in patients with chronic kidney disease. The present article examines the currently available evidence and practical implications of pharmacological disruption of RAAS activity for renal protection.
authors.affiliation: Department of Cardionephrology, University of Genoa, Azienda Ospedaliera Universitaria San Martino, Viale Benedetto XV 6, Genoa, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Leoncini
authors.forename: Leoncini
authors.initials: L
authors.lastname: Giovanna
authors.forename: Francesca
authors.initials: F
authors.lastname: Viazzi
authors.forename: Viazzi
authors.initials: V
authors.lastname: Francesca
authors.forename: Roberto
authors.initials: R
authors.lastname: Pontremoli
authors.forename: Pontremoli
authors.initials: P
authors.lastname: Roberto
mesh_terms: D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D006801:Humans; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use*; D051436:Renal Insufficiency, Chronic / Q000188:drug therapy* / Q000517:prevention & control; D000092502:Renin Inhibitors
chemical_list: D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000451:Mineralocorticoid Receptor Antagonists; D000092502:Renin Inhibitors