Current Hypertension Reports

, Volume 12, Issue 5, pp 369–377 | Cite as

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



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.


Chronic kidney disease CKD Renal disease Progression Proteinuria Renin-angiotensin-aldosterone system RAAS RAS Diabetes 

Clinical Trial Acronyms


African American Study of Kidney Disease


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


Aliskiren Trial in Type 2 Diabetes Using Cardio-Renal Endpoints


Aliskiren in the Evaluation of Proteinuria in Diabetes


Halt Progression of Polycystic Kidney Disease


Hong Kong Study using Valsartan n IgA Nephropathy


Irbesartan in Diabetic Nephropathy Trial


Modification of Diet in Renal Disease


Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial


Ramipril Efficacy in Nephropathy


Reduction of Endpoints in NIDDM with the Angiotensin II Antagonist Losartan


Veterans Affairs Nephropathy in Diabetes



Dr. Weir has received consulting fees from Amgen, Novartis, NicOx, and Daiichi Sankyo. No other potential conflicts of interest relevant to this article were reported.


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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

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

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