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Treating the kidney to cure the heart

Paolo Cravedi1, Giuseppe Remuzzi

  • 1Clinical Research Centre for Rare Diseases Aldo e Cele Daccò, Mario Negri Institute for Pharmacological Research, Villa Camozzi, Ranica, Bergamo, Italy.

Kidney International. Supplement
|November 27, 2008
PubMed

Insights

Strategies targeting chronic kidney disease (CKD) progression are crucial for reducing cardiovascular events. Renin-angiotensin system inhibition helps slow CKD, but comprehensive management is needed for better outcomes.

Area of Science:

  • Nephrology
  • Cardiology
  • Public Health

Background:

  • Global rise in chronic renal and cardiovascular diseases.
  • Renal disease is a primary risk factor for cardiovascular morbidity and mortality.
  • Effective strategies to slow renal disease progression are vital for cardiovascular event reduction.

Purpose of the Study:

  • To review the role of renin-angiotensin system inhibition in managing chronic kidney disease (CKD).
  • To discuss comprehensive strategies beyond renin-angiotensin system inhibition for improving patient outcomes.
  • To highlight the urgent need for prevention strategies, especially in developing countries.

Main Methods:

  • Review of large, randomized studies on renin-angiotensin system inhibitors (ACE inhibitors and ARBs).
  • Analysis of evidence supporting combined interventions for CKD management.
  • Examination of epidemiological trends in chronic renal and cardiovascular diseases.

Main Results:

  • Renin-angiotensin system inhibition significantly reduces renal disease progression in diabetic and non-diabetic CKD patients.
  • Improved renal outcomes correlate with reduced cardiovascular risk.
  • A significant proportion of patients still progress to end-stage renal failure or cardiovascular death despite current treatments.

Conclusions:

  • While renin-angiotensin system inhibition is effective, a multifaceted approach including blood pressure and proteinuria control, lipid management, glycemic control, and lifestyle changes is superior.
  • Enhanced prevention strategies are essential to combat the growing burden of CKD and associated cardiovascular diseases.
  • Developing countries face a disproportionately high and increasing incidence of these conditions, necessitating targeted interventions.

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