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renin angiotensin aldosterone and progression renal function

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https://www.readbyqxmd.com/read/27904025/early-raas-blockade-exerts-renoprotective-effects-in-autosomal-recessive-alport-syndrome
#1
Nao Uchida, Naonori Kumagai, Kandai Nozu, Xue Jun Fu, Kazumoto Iijima, Yoshiaki Kondo, Shigeo Kure
Alport syndrome is a progressive renal disease caused by mutations in COL4A3, COL4A4, and COL4A5 genes that encode collagen type IV alpha 3, alpha 4, and alpha 5 chains, respectively. Because of abnormal collagen chain, glomerular basement membrane becomes fragile and most of the patients progress to end-stage renal disease in early adulthood. COL4A5 mutation causes X-linked form of Alport syndrome, and two mutations in either COL4A3 or COL4A4 causes an autosomal recessive Alport syndrome. Recently, renin-angiotensin-aldosterone system (RAAS) blockade has been shown to attenuate effectively disease progression in Alport syndrome...
2016: Tohoku Journal of Experimental Medicine
https://www.readbyqxmd.com/read/27754186/sp-04-1-the-role-of-natriuretic-peptides-in-the-pathogenesis-of-cardiovascular-diseases
#2
Zhanna Kobalava
The burden of cardiovascular diseases (CVD) in general and heart failure (HF) in particular continues to increase worldwide. CVD are major contributors to death and morbidity and recognized as important drivers of healthcare expenditure. Chronic overactivity of the renin-angiotensin-aldosterone system (RAAS) plays a key role in human hypertension and HF pathophysiology. RAAS is fundamental in the overall regulation of cardiovascular homeostasis through the actions of hormones, which regulate vascular tone, and specifically blood pressure through vasoconstriction and renal sodium and water retention...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27753836/sy-05-2-progression-of-hypertensive-heart-disease-new-therapeutic-approach
#3
Masatsugu Horiuchi
Hypertensive patients have greater chances of such cardiovascular events as stroke, coronary heart disease, heart or renal failure, peripheral artery disease, and dementia. It is also well recognized that diabetes increases the cardiovascular risks in concert with hypertension. Therefore, main goals for an innovation of anti-hypertensive therapy would be to achieve further risk reduction by targeting the functional, metabolic, and structural alterations associated with hypertension. Professors Dzau and Braunwald et al proposed the concept of "the cardiovascular disease continuum" in 1991, and that hypertension may trigger the chain of events, leading to end-stage heart disease; however, this concept was quite new at that time, and there was some discussion whether "the cardiovascular disease continuum" is true or not...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27643143/sp-04-1-the-role-of-natriuretic-peptides-in-the-pathogenesis-of-cardiovascular-diseases
#4
Zhanna Kobalava
The burden of cardiovascular diseases (CVD) in general and heart failure (HF) in particular continues to increase worldwide. CVD are major contributors to death and morbidity and recognized as important drivers of healthcare expenditure. Chronic overactivity of the renin-angiotensin-aldosterone system (RAAS) plays a key role in human hypertension and HF pathophysiology. RAAS is fundamental in the overall regulation of cardiovascular homeostasis through the actions of hormones, which regulate vascular tone, and specifically blood pressure through vasoconstriction and renal sodium and water retention...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27642889/sy-05-2-progression-of-hypertensive-heart-disease-new-therapeutic-approach
#5
Masatsugu Horiuchi
Hypertensive patients have greater chances of such cardiovascular events as stroke, coronary heart disease, heart or renal failure, peripheral artery disease, and dementia. It is also well recognized that diabetes increases the cardiovascular risks in concert with hypertension. Therefore, main goals for an innovation of anti-hypertensive therapy would be to achieve further risk reduction by targeting the functional, metabolic, and structural alterations associated with hypertension. Professors Dzau and Braunwald et al proposed the concept of "the cardiovascular disease continuum" in 1991, and that hypertension may trigger the chain of events, leading to end-stage heart disease; however, this concept was quite new at that time, and there was some discussion whether "the cardiovascular disease continuum" is true or not...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27609359/effect-of-mineralocorticoid-receptor-antagonists-on-proteinuria-and-progression-of-chronic-kidney-disease-a-systematic-review-and-meta-analysis
#6
Gemma Currie, Alison H M Taylor, Toshiro Fujita, Hiroshi Ohtsu, Morten Lindhardt, Peter Rossing, Lene Boesby, Nicola C Edwards, Charles J Ferro, Jonathan N Townend, Anton H van den Meiracker, Mohammad G Saklayen, Sonia Oveisi, Alan G Jardine, Christian Delles, David J Preiss, Patrick B Mark
BACKGROUND: Hypertension and proteinuria are critically involved in the progression of chronic kidney disease. Despite treatment with renin angiotensin system inhibition, kidney function declines in many patients. Aldosterone excess is a risk factor for progression of kidney disease. Hyperkalaemia is a concern with the use of mineralocorticoid receptor antagonists. We aimed to determine whether the renal protective benefits of mineralocorticoid antagonists outweigh the risk of hyperkalaemia associated with this treatment in patients with chronic kidney disease...
September 8, 2016: BMC Nephrology
https://www.readbyqxmd.com/read/27476173/renin-angiotensin-aldosterone-system-antagonism-and-polycystic-kidney-disease-progression
#7
Chuan Kai Hian, Chin Liang Lee, Warren Thomas
Autosomal Dominant Polycystic Kidney Disease (ADPKD) is a systemic disease characterised by the formation of multiple renal cysts that adversely affect renal function. ADPKD shows significant progression with age when complications due to hypertension are most significant. The activation of the renin-angiotensin-aldosterone system (RAAS) occurs in progressive kidney disease leading to hypertension. The RAAS system may also contribute to ADPKD progression by stimulating signalling pathways in the renal cyst cells to promote growth and deregulate epithelial transport...
2016: Nephron
https://www.readbyqxmd.com/read/27442639/hyperaldosteronism-and-cardiovascular-risk-in-patients-with-autosomal-dominant-polycystic-kidney-disease
#8
Silvia Lai, Luigi Petramala, Daniela Mastroluca, Emanuela Petraglia, Alessandro Di Gaeta, Elena Indino, Valeria Panebianco, Mauro Ciccariello, Hossein H Shahabadi, Alessandro Galani, Claudio Letizia, Anna Rita D'Angelo
Hypertension is commonly associated with autosomal dominant polycystic kidney disease (ADPKD), often discovered before the onset of renal failure, albeit the pathogenetic mechanisms are not well elucidated. Hyperaldosteronism in ADPKD may contribute to the development of insulin resistance and endothelial dysfunction, and progression of cardiorenal disease. The aim of study was to evaluate the prevalence of primary aldosteronism (PA) in ADPKD patients and identify some surrogate biomarkers of cardiovascular risk...
July 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27440829/sglt2-inhibitors-and-the-diabetic-kidney
#9
Paola Fioretto, Alberto Zambon, Marco Rossato, Luca Busetto, Roberto Vettor
Diabetic nephropathy (DN) is the most common cause of end-stage renal disease worldwide. Blood glucose and blood pressure control reduce the risk of developing this complication; however, once DN is established, it is only possible to slow progression. Sodium-glucose cotransporter 2 (SGLT2) inhibitors, the most recent glucose-lowering oral agents, may have the potential to exert nephroprotection not only through improving glycemic control but also through glucose-independent effects, such as blood pressure-lowering and direct renal effects...
August 2016: Diabetes Care
https://www.readbyqxmd.com/read/27186263/an-additive-effect-of-eplerenone-to-ace-inhibitor-on-slowing-the-progression-of-diabetic-nephropathy-in-the-db-db-mice
#10
Guangyu Zhou, Ulrika Johansson, Xiao-Rong Peng, Krister Bamberg, Yufeng Huang
Although blockade of the renin-angiotensin-system (RAS) has become standard therapy for diabetic nephropathy (DN), decline in kidney function towards end-stage renal disease is seen in many patients. Elevated plasma aldosterone often accompanies RAS blockade by a phenomenon known as "aldosterone escape" and activates the mineralocorticoid receptor (MR). We therefore examined whether addition of the MR antagonist eplerenone to an ACEI would enhance the efficacy in slowing the progression of DN. Untreated uninephrectomized diabetic db/db mice developed progressive albuminuria and glomerulosclerosis between weeks 18 and 22, associated with decreased number of podocytes and increased renal expression of fibrotic markers...
2016: American Journal of Translational Research
https://www.readbyqxmd.com/read/27041482/sodium-intake-raas-blockade-and-progressive-renal-disease
#11
REVIEW
Martin H de Borst, Gerjan Navis
Pharmacological blockade of the renin-angiotensin-aldosterone system (RAAS) by angiotensin converting enzyme inhibitors or angiotensin receptor blockers is the current standard treatment to prevent progressive renal function loss in patients with chronic kidney disease. Yet in many patients the renal protective effect of RAAS-blockade is incomplete. Short-term clinical studies have demonstrated that dietary sodium restriction potentiates the antiproteinuric effect of RAAS-blockade. More recently, it was shown that this effect is accompanied by a lower risk of end-stage renal disease and adverse cardiovascular outcomes...
May 2016: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/27032877/kidney-and-aging-a-narrative-review
#12
Michael Gekle
The kidney undergoes age-related changes, reaching full functionality after the age of 5years and suffering a slow but progressive decline in its regulatory range of function (e.g. matching sodium and potassium excretion to dietary intake), starting at the age of ~20years, as well as in function (e.g. glomerular filtration) starting at a higher age. Age-related decline in renal function is also a matter of gender, race and genetic background. Pathogenetically, mediators of chronic inflammation, oxidative stress and the renin-angiotensin-aldosterone (RAAS) system are relevant factors determining renal aging, due to an enhanced incidence of cellular damage combined with reduced repair capacities...
March 24, 2016: Experimental Gerontology
https://www.readbyqxmd.com/read/27009050/dual-inhibition-of-renin-angiotensin-aldosterone-system-and-endothelin-1-in-treatment-of-chronic-kidney-disease
#13
REVIEW
Radko Komers, Horacio Plotkin
Inhibition of the renin-angiotensin-aldosterone system (RAAS) plays a pivotal role in treatment of chronic kidney diseases (CKD). However, reversal of the course of CKD or at least long-term stabilization of renal function are often difficult to achieve, and many patients still progress to end-stage renal disease. New treatments are needed to enhance protective actions of RAAS inhibitors (RAASis), such as angiotensin-converting enzyme (ACE) inhibitors (ACEIs) or angiotensin receptor blockers (ARBs), and improve prognosis in CKD patients...
May 15, 2016: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/27007719/the-promise-of-mesenchymal-stem-cell-therapy-for-diabetic-kidney-disease
#14
REVIEW
Tomás P Griffin, William Patrick Martin, Nahidul Islam, Timothy O'Brien, Matthew D Griffin
Diabetes mellitus (DM) commonly leads to progressive chronic kidney disease despite current best medical practice. The pathogenesis of diabetic kidney disease (DKD) involves a complex network of primary and secondary mechanisms with both intra-renal and systemic components. Apart from inhibition of the renin angiotensin aldosterone system, targeting individual pathogenic mediators with drug therapy has not, thus far, been proven to have high clinical value. Stem or progenitor cell therapies offer an alternative strategy for modulating complex disease processes through suppressing multiple pathogenic pathways and promoting pro-regenerative mechanisms...
May 2016: Current Diabetes Reports
https://www.readbyqxmd.com/read/26894033/comprehensive-approach-to-diabetic-nephropathy
#15
REVIEW
Bancha Satirapoj, Sharon G Adler
Diabetic nephropathy (DN) is a leading cause of mortality and morbidity in patients with diabetes. This complication reflects a complex pathophysiology, whereby various genetic and environmental factors determine susceptibility and progression to end-stage renal disease. DN should be considered in patients with type 1 diabetes for at least 10 years who have microalbuminuria and diabetic retinopathy, as well as in patients with type 1 or type 2 diabetes with macroalbuminuria in whom other causes for proteinuria are absent...
September 2014: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/26887332/combination-therapy-with-renin-angiotensin-aldosterone-system-inhibitor-telmisartan-and-serine-protease-inhibitor-camostat-mesilate-provides-further-renoprotection-in-a-rat-chronic-kidney-disease-model
#16
Yuki Narita, Miki Ueda, Kohei Uchimura, Yutaka Kakizoe, Yoshikazu Miyasato, Teruhiko Mizumoto, Jun Morinaga, Manabu Hayata, Terumasa Nakagawa, Masataka Adachi, Taku Miyoshi, Yoshiki Sakai, Daisuke Kadowaki, Sumio Hirata, Masashi Mukoyama, Kenichiro Kitamura
We previously reported that camostat mesilate (CM) had renoprotective and antihypertensive effects in rat CKD models. In this study, we examined if CM has a distinct renoprotective effect from telmisartan (TE), a renin-angiotensin-aldosterone system (RAS) inhibitor, on the progression of CKD. We evaluated the effect of CM (400 mg/kg/day) and/or TE (10 mg/kg/day) on renal function, oxidative stress, renal fibrosis, and RAS components in the adenine-induced rat CKD model following 5-weeks treatment period. The combination therapy with CM and TE significantly decreased the adenine-induced increase in serum creatinine levels compared with each monotherapy, although all treatment groups showed similar reduction in blood pressure...
February 2016: Journal of Pharmacological Sciences
https://www.readbyqxmd.com/read/26848302/hypertension-in-chronic-glomerulonephritis
#17
REVIEW
Chun-Gyoo Ihm
Chronic glomerulonephritis (GN), which includes focal segmental glomerulosclerosis and proliferative forms of GN such as IgA nephropathy, increases the risk of hypertension. Hypertension in chronic GN is primarily volume dependent, and this increase in blood volume is not related to the deterioration of renal function. Patients with chronic GN become salt sensitive as renal damage including arteriolosclerosis progresses and the consequent renal ischemia causes the stimulation of the intrarenal renin-angiotensin-aldosterone system(RAAS)...
December 2015: Electrolyte & Blood Pressure: E & BP
https://www.readbyqxmd.com/read/26519114/beneficial-long-term-effect-of-aldosterone-antagonist-added-to-a-traditional-blockade-of-the-renin-angiotensin-aldosterone-system-among-patients-with-obesity-and-proteinuria
#18
Enrique Morales, Eduardo Gutiérrez, Jara Caro, Angel Sevillano, Jorge Rojas-Rivera, Manuel Praga
INTRODUCTION: Over the past decade, obesity has become a risk factor for developing chronic kidney disease. Proteinuria is known to be an independent determinant of the progression of chronic kidney disease, and adipose tissue is a recognized source of components of the renin-angiotensin-aldosterone system (RAAS). Recent studies have shown that plasma aldosterone levels are disproportionately higher in patients with obesity. Drugs that block the RAAS are unable to inhibit aldosterone in the long term...
November 2015: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
https://www.readbyqxmd.com/read/26450935/plasma-vitamin-d-level-and-change-in-albuminuria-and-egfr-according-to-sodium-intake
#19
Charlotte A Keyzer, Hiddo J Lambers-Heerspink, Michel M Joosten, Petronella E Deetman, Ron T Gansevoort, Gerjan Navis, Ido P Kema, Dick de Zeeuw, Stephan J L Bakker, Martin H de Borst
BACKGROUND AND OBJECTIVES: Low circulating 25-hydroxyvitamin D [25(OH)D] and high sodium intake are both associated with progressive albuminuria and renal function loss in CKD. Both vitamin D and sodium intake interact with the renin-angiotensin-aldosterone system. We investigated whether plasma 25(OH)D or 1,25-dihydroxyvitamin D [1,25(OH)2D] is associated with developing increased albuminuria or reduced renal function and whether these associations depend on sodium intake. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Baseline plasma 25(OH)D and 1,25(OH)2D were measured by liquid chromatography tandem mass spectrometry, and sodium intake was assessed by 24-hour urine collections in the general population-based Prevention of Renal and Vascular End-Stage Disease cohort (n=5051)...
December 7, 2015: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/26429974/multicentre-randomized-controlled-trial-of-angiotensin-converting-enzyme-inhibitor-angiotensin-receptor-blocker-withdrawal-in-advanced-renal-disease-the-stop-acei-trial
#20
RANDOMIZED CONTROLLED TRIAL
Sunil Bhandari, Natalie Ives, Elizabeth A Brettell, Marie Valente, Paul Cockwell, Peter S Topham, John G Cleland, Arif Khwaja, Meguid El Nahas
BACKGROUND: Blood pressure (BP) control and reduction of urinary protein excretion using agents that block the renin-angiotensin aldosterone system are the mainstay of therapy for chronic kidney disease (CKD). Research has confirmed the benefits in mild CKD, but data on angiotensin-converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB) use in advanced CKD are lacking. In the STOP-ACEi trial, we aim to confirm preliminary findings which suggest that withdrawal of ACEi/ARB treatment can stabilize or even improve renal function in patients with advanced progressive CKD...
February 2016: Nephrology, Dialysis, Transplantation
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