Aldosterone Blockade in Chronic Kidney Disease

Hirsch, Jamie S.; Drexler, Yelena; Bomback, Andrew S.

doi:10.1016/j.semnephrol.2014.04.006

Cited by 21 publications

(21 citation statements)

References 158 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…That was due to reduction of aldosterone levels by about 65%, as dual RAAS blockade, with ACE-Is and ARB with improvement in blood pressure and proteinuria [25].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of combined vs. single renin-angiotensin-aldosterone system blockade in chronic kidney disease

Abdelrahman¹,

Genina²,

Said³

et al. 2016

Med-Science

View full text Add to dashboard Cite

Hypertension and proteinuria are well-known predictors of chronic kidney disease (CKD) progression. Therapeutic interventions have different magnitude of albuminuria and hypertension. This study was designed to evaluate the efficacy and safety of combined vs. single renin-angiotensin-aldosterone system (RAAS) blockade in chronic kidney disease. Forty (28 female) patients with chronic kidney diseases were collected from nephrology outpatient clinic, internal medicine department, Beni Suef University hospital. They were divided randomly into 2 groups. Group A was 24 (20 females) patients treated with Enalapril, as angiotensin converting enzyme inhibitor (ACE-I) alone. Group B was 16 (8 females) patients treated with combination of Enalapril and Irbesartan, as angiotensin receptor blocker (ARB). All patients were subjected to full history taking; thorough clinical examination; certain laboratory tests and renal function tests at the start of the study, 1.5 and 3 months later. Proteinuria, urinary albumin/creatinine ratio (UACR), systolic blood pressure (SBP) and glomerular filtration rate (GFR) were significantly (p<0.001) decreased with dual therapy (ACE-I and ARB) compared to monotherapy. In return serum potassium level (Ser.K), serum creatinine level (Ser.Cr) were significantly increased (p<0.001) with dual therapy (ACE-I and ARB) compared to monotherapy. The hypotensive and antiproteinuric effect of RAAS inhibitors should be compared with hyperkalemia and rise in serum creatinine level when prescribed as monothrapy or combination in patients with CKD. Decision of usage of RAAS blockade should be made based on the risk and benefit ratio.

show abstract

“…That was due to reduction of aldosterone levels by about 65%, as dual RAAS blockade, with ACE-Is and ARB with improvement in blood pressure and proteinuria [25].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of combined vs. single renin-angiotensin-aldosterone system blockade in chronic kidney disease

Abdelrahman¹,

Genina²,

Said³

et al. 2016

Med-Science

View full text Add to dashboard Cite

show abstract

“…The addition of aldosterone antagonists whether non-selective (spironolactone) or selective (eplerenone or Finerenone) to anti-hypertension medications offered better BP and proteinuria control in mild to moderate CKD [83][84][85] . Hyperkalemia is not infrequent with RAS blockers and/or aldosterone antagonists treatment in such patients.…”

Section: Pathogenesismentioning

confidence: 99%

Stop chronic kidney disease progression: Time is approaching

Din¹,

Salem²,

Abdulazim³

2016

WJN

View full text Add to dashboard Cite

Progression of chronic kidney disease (CKD) is inevitable. However, the last decade has witnessed tremendous achievements in this field. Today we are optimistic; the dream of withholding this progression is about to be realistic. The recent discoveries in the field of CKD management involved most of the individual diseases leading the patients to end-stage renal disease. Most of these advances involved patients suffering diabetic kidney disease, chronic glomerulonephritis, polycystic kidney disease, renal amyloidosis and chronic tubulointerstitial disease. The chronic systemic inflammatory status and increased oxidative stress were also investigated. This inflammatory status influences the antisenescence Klotho gene expression. The role of Klotho in CKD progression together with its therapeutic value are explored. The role of gut as a major source of inflammation, the pathogenesis of intestinal mucosal barrier damage, the role of intestinal alkaline phosphatase and the dietary and therapeutic implications add a novel therapeutic tool to delay CKD progression.

show abstract

“…Data are still lacking in relation to how MRAs affect progression to end-stage renal disease and overall mortality. 20 Potent vasodilators, such as hydralazine, are effective when added to a medication treatment regimen. However, hydralazine usually requires concomitant therapy with a diuretic and b-blocker.…”

Section: Medication Managementmentioning

confidence: 99%