Chronic Renal Diseases: Renoprotective Benefits of ReninAngiotensin System Inhibition

@article{Remuzzi2002ChronicRD,
  title={Chronic Renal Diseases: Renoprotective Benefits of ReninAngiotensin System Inhibition},
  author={Giuseppe Remuzzi and Piero Ruggenenti and Norberto Perico},
  journal={Annals of Internal Medicine},
  year={2002},
  volume={136},
  pages={604-615}
}
Certain renal diseases seen in clinical practice, such as rapidly progressive glomerulonephritis, have a very rapid course that soon leads to irreversible end-stage renal failure caused by complete structural damage. These diseases, however, are rare. The more common nephropathies, which progress more slowly, still evolve to end-stage renal failure. Diabetes mellitus or hypertension can, in some patients, cause renal injury that progresses to renal failure and the need for kidney replacement… Expand
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References

SHOWING 1-10 OF 96 REFERENCES
Progression, remission, regression of chronic renal diseases
TLDR
Experimental and clinical data lend support to the notion that less dialysis (and maybe none for some patients) is at least possible, and the notion of renoprotection is developing into a combined approach to renal diseases. Expand
Blood Pressure Control, Proteinuria, and the Progression of Renal Disease
TLDR
The MDRD Study compared the rates of decline in glomerular filtration rate in 840 patients with a diverse array of renal diseases who were randomly assigned to either a usual or a low blood pressure goal and evaluated the effect of blood pressure on changes in proteinuria. Expand
Effect of the Angiotensin-Converting–Enzyme Inhibitor Benazepril on the Progression of Chronic Renal Insufficiency
TLDR
A study to determine the effect of the angiotensin-converting–enzyme inhibitor benazepril on the progression of renal insufficiency in patients with various underlying renal diseases. Expand
Dietary protein intake and the progressive nature of kidney disease: the role of hemodynamically mediated glomerular injury in the pathogenesis of progressive glomerular sclerosis in aging, renal ablation, and intrinsic renal disease.
TLDR
With the development and increasingly widespread availability of dialysis and transplantation in the past three decades, relatively little attention has been paid to the influence of diet on the progression of renal disease, despite general awareness that renal disease typically follows an inexorably progressive course. Expand
Pathophysiology of progressive nephropathies.
In patients with renal diseases characterized by proteinuria, the initial insult to the kidney is usually followed by a progressive decline in the glomerular filtration rate. This decline has beenExpand
ACE inhibition induces regression of proteinuria and halts progression of renal damage in a genetic model of progressive nephropathy.
TLDR
In proteinuric MWF rats, late-onset ACE inhibition normalized blood pressure, effectively and progressively restored high protein excretion rate toward normal values, and arrested progression of tissue damage. Expand
Passive Heymann nephritis: evidence that angiotensin-converting enzyme inhibition reduces proteinuria and retards renal structural injury.
TLDR
The effect of perindopril on proteinuria and renal structural damage was associated with a significant reduction in urinary ET-1 but not TGF-beta 1, suggesting thatET-1 may be an important determinant of disease progression in experimental membranous nephropathy. Expand
Remission and regression in the nephropathy of type 1 diabetes when blood pressure is controlled aggressively.
TLDR
It is suggested that aggressive antihypertensive treatment in type 1 diabetic patients can induce remission and regression in a sizable fraction of patients with diabetic nephropathy. Expand
Effect of the angiotensin-converting-enzyme inhibitor benazepril on the progression of chronic renal insufficiency. The Angiotensin-Converting-Enzyme Inhibition in Progressive Renal Insufficiency Study Group.
TLDR
Benazepril provides protection against the progression of renal insufficiency in patients with various renal diseases and was not effective in Patients with polycystic disease. Expand
Therapeutic advantage of converting enzyme inhibitors in arresting progressive renal disease associated with systemic hypertension in the rat.
TLDR
Control of systemic blood pressure is insufficient to prevent progressive renal injury in rats with reduced renal mass, and failure of triple drug therapy to control glomerular hypertension was associated with progressive proteinuria and glomersular lesions comparable to those seen in untreated group 4 rats. Expand
...
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2
3
4
5
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