Current Hypertension Reports

, Volume 12, Issue 5, pp 369–377

Does Blockade of the Renin-Angiotensin-Aldosterone System Slow Progression of All Forms of Kidney Disease?

Article

DOI: 10.1007/s11906-010-0142-2

Cite this article as:
Lattanzio, M.R. & Weir, M.R. Curr Hypertens Rep (2010) 12: 369. doi:10.1007/s11906-010-0142-2

Abstract

The velocity of chronic kidney disease (CKD) progression is only partly dependent on the nature and activity of the underlying disease process. Activation of the renin-angiotensin-aldosterone system (RAAS) is a crucial, and often universal, event responsible for the pathophysiologic mechanisms that accelerate CKD progression. Thus, it would appear that interruption of the RAAS through the use of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, mineralocorticoid receptor antagonists, or direct renin inhibitors can play a principal role in slowing CKD progression, regardless of the cause. Unfortunately, applying this generalized approach to all forms of CKD has been delayed by the lack of strong, evidence-based data. The aim of this review is to provide the most current evidence available for the use of RAAS blockade as a method of slowing the progression of the various forms of CKD.

Keywords

Chronic kidney diseaseCKDRenal diseaseProgressionProteinuriaRenin-angiotensin-aldosterone systemRAASRASDiabetes

Clinical Trial Acronyms

AASK

African American Study of Kidney Disease

ACCOMPLISH

Avoiding Cardiovascular Events through Combination Therapy in Patients Living with Systolic Hypertension

ALTITUDE

Aliskiren Trial in Type 2 Diabetes Using Cardio-Renal Endpoints

AVOID

Aliskiren in the Evaluation of Proteinuria in Diabetes

HALT PKD

Halt Progression of Polycystic Kidney Disease

HKVIN

Hong Kong Study using Valsartan n IgA Nephropathy

IDNT

Irbesartan in Diabetic Nephropathy Trial

MDRD

Modification of Diet in Renal Disease

ONTARGET

Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial

REIN

Ramipril Efficacy in Nephropathy

RENAAL

Reduction of Endpoints in NIDDM with the Angiotensin II Antagonist Losartan

VA NEPHRON-D

Veterans Affairs Nephropathy in Diabetes

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Division of NephrologyUniversity of Maryland School of Medicine Medical CenterBaltimoreUSA