[Renoprotective effects of antihypertensives]

A characteristic feature of a majority of chronic renal diseases is their progressive course. The speed of deterioration of renal function depends besides an aetiology of a primary disease on the level of systemic (and glomerular) blood pressure and a degree of proteinuria. Angiotensin II plays an important role in the use of hemodynamic and nonhemodynamic factors of progression. Inhibitors of angiotensin converting enzyme or angiotensin antagonists comparable with other hypertensives used in blood pressure control have more substantial renoprotective effects both in diabetic and nondiabetic kidney diseases. A prerequisite of an effective renal protection is reaching the target blood pressure corresponding with present European and American recommended values < or = 130/80 mm Hg. The least risk of chronic renal disease progression is when systolic blood pressure is 110-120 mm Hg and in proteinuria plain 1 g/24 hod. A practical implementation of renal protection is difficult in patients with renal insufficiency in spite of the used combination of angiotensin converting enzyme inhibitors or angiotensin antagonists and other antihypertensives.