Renin-angiotensin system antagonists, glomerular filtration rate and blood pressure

Authors

DOI:

https://doi.org/10.22141/2307-1257.7.1.2018.122214

Keywords:

renin-angiotensin system antagonists, glomerular filtration rate, blood pressure, chronic kidney disease, the relationship of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers and glomerular filtration rate

Abstract

The article deals with the Modern data on the influence of renin-angiotensin system blockers on the glomerular filtration rate, the level of arterial pressure and the outcome of chronic kidney disease. The strategy of  rennin-angiotensine blockade is offered to be changed depending on the criteria va­lues of glomerular filtration rate: a combination of inhibitors of angiotensin-converting enzyme + angiotensin receptors blo­ckers, monotherapy and drug withdrawal in glomerular filtration rate under 15–30 ml/min/m2. The formula BRIMONEL for treatment of chronic kidney disease is given.

Downloads

Download data is not yet available.

References

Vejakama P, Ingsathi A, McKay GJ, et al. Treatment effects of renin-angiotensin aldosterone system blockade on kidney failure and mortality in chronic kidney disease patients. BMC Nephrol. 2017 Nov 29;18(1):342. doi: 10.1186/s12882-017-0753-9.

Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int. Suppl. 2013;3:1-150.

National Institute for Health and Care Excellence (NICE). Chronic kidney disease in adults: assessment and management. Clinical guideline. Available from: https://www.nice.org.uk/guidance/cg182/chapter/1-recommendations. Accessed: July 2014.

Ivanov DD, Kushnirenko SV. BRA II1+ ACEI vs BRA II1+ ACEI+ COX-2 inhibitor vs BRA II1+ ACEI+ moxonidin in patients with diabetic nephropathy (DN). In: Proceeding of the XLII ERAEDTA Congress. 2005, June 4-7; Istanbul, Turkey. Nephrol Dial Transplant. 2005;20 suppl 5:V240-V240.

Maione A, Navaneethan SD, Graziano G, et al. Angiotensin-converting enzyme inhibitors, angiotensin receptor blockers and combined therapy in patients with micro- and macroalbuminuria and other cardiovascular risk factors: a systematic review of randomized controlled trials. Nephrol Dial Transplant. 2011 Sep;26(9):2827-47. doi: 10.1093/ndt/gfq792.

Schmidt M, Mansfield KE, Bhaskaran K, et al. Serum Creatinine Elevation After Renin-angiotensin System Blockade and Long Term Cardiorenal Risks. BMJ. 2017 Mar 9;356:j791. doi: 10.1136/bmj.j791.

Lin CC, Wu YT, Yang WC, et al. Angiotensin receptor blockers are associated with lower mortality than ACE inhibitors in predialytic stage 5 chronic kidney disease: A nationwide study of therapy with reninangiotensinsystem blockade. PLoS One. 2017 Dec 7;12(12):e0189126. doi: 10.1371/journal.pone.0189126.

ONTARGET Investigators, Yusuf S, Teo KK, et al. Telmisartan, ramipril, or both in patients at high risk for vascular events. N Engl J Med. 2008 Apr 10;358(15):1547-59. doi: 10.1056/NEJMoa0801317.

Introduction: Standards of Medical Care in Diabetes-2018. Diabetes Care. 2018 Jan;41(Suppl 1):S1-S2. doi: 10.2337/dc18-Sint01.

Ivanov DD. When should we start using angiotensin converting enzyme inhibitors/angiotensin receptor blockers in diabetic kidney disease? Pochki. 2017; 6(1):31-35. doi: 10.22141/2307-1257.6.1.2017.93781.

Ivanov DD. Next step in chronic kidney disease therapy. Pochki. 2016; 5(2):10-13. doi: 10.22141/2307-1257.0.2.16.2016.72205.

Miura S, Karnik SS, Saku K. Review: angiotensin II type 1 receptor blockers: class effects versus molecular effects. J Renin Angiotensin Aldosterone Syst. 2011 Mar;12(1):1-7. doi: 10.1177/1470320310370852.

Ahmed AK, Kamath NS, El Kossi M, El Nahas AM. The impact of stopping inhibitors of the renin-angiotensin system in patients with advanced chronic kidney disease. Nephrol Dial Transplant. 2010 Dec;25(12):3977-82. doi: 10.1093/ndt/gfp511.

Gant CM, Laverman GD, Vogt L, et al. Renoprotective RAAS inhibition does not affect the association between worse renal function and higher plasma aldosterone levels. BMC Nephrol. 2017 Dec 20;18(1):370. doi: 10.1186/s12882-017-0789-x.

Georgianos PI, Agarwal R. Revisiting RAAS blockade in CKD with newer potassium-binding drugs. Kidney Int. 2017 Dec 21. pii: S0085-2538(17)30808-6. doi: 10.1016/j.kint.2017.08.038.

Böhm M, Schumacher H, Teo KK, et al. Achieved blood pressure and cardiovascular outcomes in high-risk patients: results from ONTARGET and TRANSCEND trials. Lancet. 2017 Jun 3;389(10085):2226-2237. doi: 10.1016/S0140-6736(17)30754-7.

SPRINT Research Group, Wright JT Jr, Williamson JD, et al. A randomized trial of intensive versus standard blood-pressure control. N Engl J Med. 2015 Nov 26;373(22):2103-16. doi: 10.1056/NEJMoa1511939.

Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension. 2017 Nov 13. pii: HYP.0000000000000065. doi: 10.1161/HYP.0000000000000065.

Basy S, Sussman JB, Hayward RA. Detecting Heterogeneous Treatment Effects to Guide Personalized Blood Pressure Treatment: A Modeling Study of Randomized Clinical Trials. Ann Intern Med. 2017 Mar 7;166(5):354-360. doi: 10.7326/M16-1756.

Mark PB. Strategies to manage cardiovascular risk in chronic kidney disease. Nephrol Dial Transplant. 2018 Jan 1;33(1):23-25. doi: 10.1093/ndt/gfx329.

Published

2021-09-08

How to Cite

Ivanov, D. (2021). Renin-angiotensin system antagonists, glomerular filtration rate and blood pressure. KIDNEYS, 7(1), 6–10. https://doi.org/10.22141/2307-1257.7.1.2018.122214

Issue

Section

Guest Articles