Renovascular and renoprotective properties of telmisartan: clinical utility

Chronic kidney disease (CKD) affects approximately 26 million adults in the United States and millions of others are at increased risk. Type 2 diabetes and hypertension are the two main causes of CKD. Blood pressure control is critical to slow the progression of CKD. Despite adequate control, however, patients continue to progress to end-stage renal disease. Angiotensin receptor blockers (ARBs) are commonly used in the management of hypertension and CKD and have been shown to exert renoprotective effects that are in addition to, but independent of, blood pressure lowering. Telmisartan is a long-acting ARB with pharmacological properties beyond blockade of the angiotensin II type 1 receptor, including activation of the peroxisome proliferator activated receptor-γ (PPAR-γ). This article reviews the beneficial renal and vascular protective effects of telmisartan.