Renin-angiotensin-aldosterone system blockers as the main pathogenetic approach of drug nephroprotection

Abstract

The paper considers the modern trends in the therapy of nephrologic pathology with nosotropic justification of the predominant role of renin-angiotensin-aldosterone system (RAAS) blockers in modern nephroprotection. The attention is paid to the fact that the pathogenesis of kidney diseases is inevitably associated with the state of RAAS, whose adaptive and compensatory possibilities are naturally changing for pathologic activation and direct involvement, namely, angiotensin II, the main effector molecule, in the structural and functional rebuilding of the kidneys. Pathogenetic therapy is virtually always directed at secondary etiology links, therefore, the modulation of the RAAS state is practically obligatory and is always an effective approach to nephroprotection. Accordingly, suppression of excessive neurohumoral effects at different levels of RAAS is practically relevant, pathogenetically justified mechanism for the preservation of functional nephrons. Administration of drugs with different pharmacodynamic properties depends on the correct selection of patients’ population, the success of therapy — on the adequate selection of RAAS blockers taking into account the clinical situation and their combination with nephroprotectors of other pharmacological classes.