Current evidence on the use of anti-RAAS agents in congenital or acquired solitary kidney

Simeoni, Mariadelina; Armeni, Annarita; Summaria, Chiara; Cerantonio, Annamaria; Fuiano, Giorgio

doi:10.1080/0886022x.2017.1361840

Cited by 20 publications

(15 citation statements)

References 52 publications

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“…Contrary to the belief that ACE inhibitors may lead to kidney damage, Simeoni M et al showed that anti-renin angiotensinaldosterone system drugs were renoprotective in patients with a solitary kidney. 23 As such, we considered the use of ACE inhibitors in our case, at an accordingly adjusted dose, but we ended up not doing so. Alongside the medical management of this child, the team concluded that watchful waiting for the need of surgical repair might be a safe path.…”

Section: Discussionmentioning

confidence: 99%

Case report discussion of management of pink tetralogy of Fallot in VACTERL association

Putra

Hendrarto

2019

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Tetralogy of Fallot (TOF) and VACTERL are considered rare entities requiring medical attention with regards to diagnosis and management. When TOF is associated with VACTERL association, case management might differ from a simple case of TOF. Tetralogy of Fallot (TOF) is defined as a complex congenital cardiac abnormality characterized by ventricular septal defect, right outflow tract obstruction, right ventricular hypertrophy, and overriding aorta.1 The term was coined in 1888 by Fallot of Marseilles, even though the defect had been described in 1673 by Steno of Denmark. The entity was then studied extensively to deliver better care management through medical and surgical approaches.2

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Section: Discussionmentioning

confidence: 99%

Case report discussion of management of pink tetralogy of Fallot in VACTERL association

Putra

Hendrarto

2019

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“…Angiotensin II is a potent vasoconstrictor, besides promoting sympathetic activation. It also induces proliferation of smooth muscle cells and increases glomerular and tubular expression of several growth factors, cytokines and chemokines, which can result in glomerular hypertrophy, sclerosis, tubulointerstitial inflammation, and fibrosis (7, 9, 20, 21). Angiotensin II is now recognized as a proinflammatory agent able to modulate immunologic and inflammatory responses in endothelial, renal tubular and smooth muscle cells, such as chemotaxis, proliferation and differentiation of monocytes into macrophages (22), whereas aldosterone, primarily promotes salt retention.…”

Section: Hypertension As a Risk Factormentioning

confidence: 99%

“…However, its degree of expression can influence progression of renal injury. Recently, Simeoni et al carried out a literature review assessing the effect of the drug in these patients (9). Despite the scarcity of related data, it was suggested that anti-RAAS agents also have a renoprotective effect in patients with a single kidney, with little evidence of serious adverse effects.…”

Section: High Blood Pressure Treatmentmentioning

confidence: 99%

“…This period can span several years and is generally followed by a phase of stability. Progressive loss of residual renal function occurs and often, at between 15 and 25 years of age, these patients require renal replacement therapy (2, 7–9). In a population-based registry of children with CAKUT (ItalKid Study), the risk of progressing to ESRD by the age of 20 was 68% (6).…”

Section: Introductionmentioning

confidence: 99%

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Management of Hypertension in CAKUT: Protective Factor for CKD

Gabriele

Nogueira

2019

Front. Pediatr.

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Patients with congenital kidney and urinary tract abnormalities (CAKUT) will often develop end-stage renal disease at some point and the need for renal replacement therapy is associated with high rates of morbidity and mortality. Hence, efforts to slow the progression of the disease are essential. Hypertension has been proven to be an independent risk factor for faster decline of glomerular filtration rate in renal patients, but studies involving only children with CAKUT are scarce. We performed a literature review to explore the association of hypertension with faster chronic kidney disease progression in children with CAKUT and also treatment options in this condition. A recent study reported an annual decline in GFR of 1.8 ml/min/1.73 m 2 among hypertensive patients with non-glomerular CKD, compared with 0.8 ml/min/1.73 m 2 in normotensive children. A multicenter prospective cohort in Brazil showed that a 1-unit increase in systolic blood pressure Z-score was associated with a 1.5-fold higher risk of disease progression. Since renin-angiotensin-aldosterone system activation is the most important mechanism of hypertension in these children, the first-line therapy involves the use of inhibitors of this axis, including angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers type I, which also promote an anti-fibrotic effect. Recent studies have shown a good safety profile for use in patients with chronic kidney disease and also in those with solitary kidneys. Hypertension is an independent risk factor for kidney disease progression and should be promptly managed for renal protection, especially among patients with CAKUT, the primary cause of chronic kidney disease in the pediatric population.

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“…Hypothyroidism is a relatively silent condition due to the lack of clinical manifestations, and can be easily ignored. High incidence rate of chronic kidney disease in patients with cardiovascular disease results in increased mortality rate (7). There is a clear relation between chronic kidney disease, cardiovascular disease and hypothyroidism demonstrated by epidemiological studies (8).…”

Section: Introductionmentioning

confidence: 99%

Favorable Effect of Levothyroxine on Nutritional Status of Patients with Stage 3-4 Chronic Kidney Disease

Tang

Chen

et al. 2018

Acta Endo (Buc)

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The aim of this study was to analyze the incidence of malnutrition in patients with stage 3-4 chronic kidney disease (CKD) and primary subclinical hypothyroidism and the effect of levothyroxine for improving nutritional status and delaying kidney disease. Patients and Methods. In the study were included 200 patients with stage 3-4 CKD: CKD3 stage group (n=100) and CKD4 stage group (n=100). These patients were further divided into: control group (non-treatment group) group a (n=65) and experiment group (treatment group) group b (n=135) according to their levothyroxine treatment. The CKD3 stage group is divided into c3 (n=35) and e3 (n=65), and CKD4 group is divided into c4 (n=30) and e4 (n=70) groups. Results. Upon treatment of subclinical hypothyroidism with levothyroxine, nutritional indicators of patients are improved, and the weight, left and right-hand grip strength, hemoglobin (HB), serum albumin are higher compared to control. After levothyroxine treatment, eGFR in the treatment group increased with each time point, while in the control group it could be seen a significant decrease. This effect was more robust in the CKD3 group than in the CKD4 group. In conclusion, levothyroxine treatment can delay the progression of kidney diseases with more efficacy in stage 3 patients.

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Current evidence on the use of anti-RAAS agents in congenital or acquired solitary kidney

Cited by 20 publications

References 52 publications

Case report discussion of management of pink tetralogy of Fallot in VACTERL association

Case report discussion of management of pink tetralogy of Fallot in VACTERL association

Management of Hypertension in CAKUT: Protective Factor for CKD

Favorable Effect of Levothyroxine on Nutritional Status of Patients with Stage 3-4 Chronic Kidney Disease

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