CJASN
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
QUICK SEARCH:   [advanced]


     

Published ahead of print on July 12, 2006
Clinical Journal of the American Society of Nephrology
© 2006 American Society of Nephrology
doi: 10.2215/CJN.02231205
This Article
Right arrow Full Text (Rapid PDF)
Right arrow All Versions of this Article:
CJN.02231205v1
1/5/1054    most recent
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Griffin, K. A.
Right arrow Articles by Bidani, A. K.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Griffin, K. A.
Right arrow Articles by Bidani, A. K.
Related Collections
Right arrowRelated Article

IN-DEPTH REVIEWS

Progression of Renal Disease: Renoprotective Specificity of Renin-Angiotensin System Blockade

Karen A. Griffin 1 and Anil K. Bidani

Loyola University Medical Center and Hines VA Hospital, Maywood, Illinois


1 To whom correspondence should be addressed. E-mail: kgriffi{at}lumc.edu.


  Abstract

Recent guidelines for management of patients with chronic kidney disease recommend both lower optimal BP targets and agents that block the renin-angiotensin system (RAS) for specific additional BP-independent renoprotection. Although there are other compelling rationales to use RAS blockade in patients with chronic kidney disease, including its antihypertensive effectiveness and ability to counteract the adverse effects of diuretics, a critical review of the available scientific evidence suggests that the specificity of renoprotection that is provided by RAS blockade has been greatly overemphasized. Little evidence of truly BP-independent renoprotection is observed in experimental animal models when ambient BP is assessed adequately by chronic continuous BP radiotelemetry. Although the clinical trial evidence is somewhat stronger, nevertheless, even when interpreted favorably, the absolute magnitude of the BP-independent component of the renoprotection that is observed with RAS blockade is much smaller than what is due to its antihypertensive effects.

Related Article

Gender Differences in the Renal Response to Renin-Angiotensin System Blockade
Judith A. Miller, David Z. Cherney, John A. Duncan, Vesta Lai, Kevin D. Burns, Christopher R.J. Kennedy, Joseph Zimpelmann, Wei Gao, Daniel C. Cattran, and James W. Scholey
J. Am. Soc. Nephrol. 2006 17: 2554-2560. [Abstract] [Full Text] [PDF]



This article has been cited by other articles:


Home page
 HypertensionHome page
K. A. Griffin and A. K. Bidani
Uncritical Acceptance of Combination Treatment of Angiotensin II Receptor Blocker and Angiotensin-Converting Enzyme Inhibitor in Nondiabetic Renal Disease Trial Results
Hypertension, January 1, 2009; 53(1): e3 - e3.
[Full Text] [PDF]

Home page
 HypertensionHome page
N. M. Kaplan
Response to Uncritical Acceptance of Combination Treatment of Angiotensin II Receptor Blocker and Angiotensin-Converting Enzyme Inhibitor in Nondiabetic Renal Disease Trial Results
Hypertension, January 1, 2009; 53(1): e4 - e4.
[Full Text] [PDF]

Home page
 HypertensionHome page
N. M. Kaplan
Recent Clinical Trials: The Good, the Bad, and the Misleading
Hypertension, October 1, 2008; 52(4): 608 - 609.
[Full Text] [PDF]

Home page
 Am. J. Physiol. Renal Physiol.Home page
S. D. Crowley, C. W. Frey, S. K. Gould, R. Griffiths, P. Ruiz, J. L. Burchette, D. N. Howell, N. Makhanova, M. Yan, H.-S. Kim, et al.
Stimulation of lymphocyte responses by angiotensin II promotes kidney injury in hypertension
Am J Physiol Renal Physiol, August 1, 2008; 295(2): F515 - F524.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Physiol. Renal Physiol.Home page
G. Piecha, N. Koleganova, M.-L. Gross, A. Geldyyev, M. Adamczak, and E. Ritz
Regression of glomerulosclerosis in subtotally nephrectomized rats: effects of monotherapy with losartan, spironolactone, and their combination
Am J Physiol Renal Physiol, July 1, 2008; 295(1): F137 - F144.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Physiol. Renal Physiol.Home page
K. A. Griffin, H. Kramer, and A. K. Bidani
Adverse renal consequences of obesity
Am J Physiol Renal Physiol, April 1, 2008; 294(4): F685 - F696.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH
Copyright © 2006 by the American Society of Nephrology.