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Blockierung des Renin-Angiotensin-Aldosteron-Systems: Einfluss auf die Progression der chronischen Nierenerkrankung
Chronic kidney diseases (CKD) are often progressive and usually associated with a relatively slow loss of function. This principally offers the opportunity for drug interventions over a prolonged period. The prerequisite is that clear therapeutic targets can be identified. One of the most important...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Medizin
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8382107/ https://www.ncbi.nlm.nih.gov/pubmed/34457077 http://dx.doi.org/10.1007/s11560-021-00525-y |
Sumario: | Chronic kidney diseases (CKD) are often progressive and usually associated with a relatively slow loss of function. This principally offers the opportunity for drug interventions over a prolonged period. The prerequisite is that clear therapeutic targets can be identified. One of the most important targets is the renin-angiotensin-aldosterone system (RAAS), the activation of which is a key contributor to the progression and deterioration of renal function. This article reviews the pathomechanistic principles of RAAS-mediated renal damage and the pharmaceutical possibilities for inhibition of the RAAS. The evidence from clinical studies on nephroprotection is summarized and the international guideline recommendations are discussed. As a future perspective, the novel possibility of a combined add-on treatment with nonsteroidal mineralocorticoid receptor antagonists is discussed based on the FIDELIO-DKD study. |
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