title: Established and Emerging Strategies in the Treatment of Chronic Kidney Disease.
abstract: Chronic kidney disease (CKD) is a common condition that has become a significant public health concern. The mainstay therapeutic approach to CKD is based on renin-angiotensin system blockade as well as blood pressure and glycemic control. Despite these interventions, the management of CKD remains suboptimal, with a large proportion of the CKD population progressing to end-stage renal disease. Newer strategies for the treatment of CKD have emerged over the past years focusing on decreasing inflammation and delaying the development of fibrosis. Despite promising results in experimental models and small randomized studies, adequately powered randomized trials are required to evaluate the benefits and risks of these therapies in the CKD population. In this review, we discuss the evidence behind, and gaps in our knowledge of, established therapies as well as newer potential strategies for managing CKD, concentrating on interventions that currently are being evaluated in randomized studies.
authors.affiliation: Department of Medicine, Renal-Electrolyte Division, University of Pittsburgh School of Medicine, Pittsburgh, PA.
authors.forename: Julio E
authors.initials: JE
authors.lastname: Pena-Polanco
authors.affiliation: Renal Section, VA Pittsburgh Healthcare System, Pittsburgh, PA; Epidemiology and Clinical and Translational Science, University of Pittsburgh, Pittsburgh, PA.
authors.forename: Linda F
authors.initials: LF
authors.lastname: Fried
mesh_terms: D000493:Allopurinol / Q000627:therapeutic use; D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D001639:Bicarbonates / Q000627:therapeutic use; D003920:Diabetes Mellitus / Q000188:drug therapy* / Q000378:metabolism; D003928:Diabetic Nephropathies / Q000188:drug therapy* / Q000517:prevention & control; D018450:Disease Progression; D065128:Endothelin Receptor Antagonists / Q000627:therapeutic use; D004872:Ergocalciferols / Q000627:therapeutic use; D016166:Free Radical Scavengers / Q000627:therapeutic use; D006442:Glycated Hemoglobin / Q000378:metabolism; D006074:Gout Suppressants / Q000627:therapeutic use; D006801:Humans; D006973:Hypertension / Q000188:drug therapy*; D033461:Hyperuricemia / Q000188:drug therapy; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007676:Kidney Failure, Chronic / Q000188:drug therapy / Q000517:prevention & control; D000451:Mineralocorticoid Receptor Antagonists / Q000627:therapeutic use*; D010431:Pentoxifylline / Q000627:therapeutic use; D011733:Pyridoxamine / Q000627:therapeutic use; D051436:Renal Insufficiency, Chronic / Q000188:drug therapy* / Q000517:prevention & control; D014803:Vitamin B Complex / Q000627:therapeutic use
chemical_list: D000493:Allopurinol; D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D001639:Bicarbonates; D065128:Endothelin Receptor Antagonists; D004872:Ergocalciferols; D016166:Free Radical Scavengers; D006442:Glycated Hemoglobin; D006074:Gout Suppressants; D007004:Hypoglycemic Agents; D000451:Mineralocorticoid Receptor Antagonists; D010431:Pentoxifylline; D011733:Pyridoxamine; D014803:Vitamin B Complex; C517652:hemoglobin A1c protein, human; C084656:paricalcitol
keywords: Chronic kidney disease; progression; renin-angiotensin system