Related Experiment Videos
Hypertension and progression of renal disease
G Maschio1, L Oldrizzi, C Marcantoni
1Division of Nephrology, University Hospital, Verona, Italy.
Insights
Systemic hypertension accelerates human kidney disease. Angiotensin-converting-enzyme inhibitors (ACE-inhibitors) significantly reduce disease progression and blood pressure in patients with non-diabetic kidney disease.
Area of Science:
- Nephrology
- Cardiovascular Medicine
- Pharmacology
Background:
- Systemic hypertension is a known contributor to the progression of human renal disease.
- The impact of antihypertensive treatments on renal disease progression provides clinical evidence for this link.
Purpose of the Study:
- To evaluate the renoprotective effects of different antihypertensive agents.
- To compare the efficacy of angiotensin-converting-enzyme inhibitors (ACE-inhibitors) against conventional agents and calcium channel blockers in preserving kidney function.
Main Methods:
- Observational studies and dietary protein restriction studies were reviewed.
- Clinical trials comparing various antihypertensive agents were analyzed.
- Statistical analysis was employed to assess the impact of ACE-inhibitors on renal functional deterioration.
Main Results:
- ACE-inhibitors demonstrated superior renoprotective effects compared to conventional agents and calcium channel blockers.
- In patients with non-diabetic nephropathies, ACE-inhibitors reduced the risk of progressive renal functional deterioration by approximately half.
- This renoprotection was linked to significant reductions in systemic blood pressure and proteinuria.
Conclusions:
- ACE-inhibitors offer significant renoprotection in patients with non-diabetic kidney disease.
- The findings suggest both blood pressure reduction and a potential direct effect of ACE-inhibitors on the kidney contribute to their renoprotective benefits.
Abstract:
That systemic hypertension is involved in the progression of human renal disease is mostly suggested by the way anti-hypertensive treatment affects the course of the disease. Clinical evidence has been obtained from observational studies as well as from studies of dietary protein restriction. In addition, several trials have compared the effects of different antihypertensive agents. The angiotensin-converting-enzyme inhibitors have the best renoprotective effect when compared to conventional agents and calcium channel blockers. In most studies, ACE-inhibitors approximately halved the risk of progressive renal functional deterioration in patients with non-diabetic nephropathies; this protection was associated with a significant reduction in systemic blood pressure and proteinuria. Statistical analysis, however, also suggests a direct effect of ACE-inhibitors on the kidney.