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[Classical nephroprotection: Renin angiotensin aldosterone system inhibitors]

M I Egocheaga1, Y Drak2, V Otero3

  • 1Centro de salud Isla de Oza, Madrid, España.

Semergen
|June 24, 2023
PubMed

Insights

Renin angiotensin aldosterone system (RAAS) inhibitors are crucial for treating chronic kidney disease (CKD) and reducing albuminuria. Careful dosing and monitoring are essential to manage side effects like hyperkalemia.

Area of Science:

  • Cardiovascular Medicine
  • Nephrology
  • Pharmacology

Context:

  • The renin angiotensin aldosterone system (RAAS) plays a key role in hypertension, cardiovascular disease, and kidney disease.
  • RAAS inhibitors are standard treatments for chronic kidney disease (CKD).

Purpose:

  • To review the role of RAAS inhibitors in managing CKD and associated cardiovascular risks.
  • To highlight the benefits and controversies surrounding RAAS inhibitor use in specific CKD populations.

Summary:

  • Angiotensin-converting enzyme inhibitors (ACE inhibitors) and angiotensin II receptor blockers (ARBs) reduce albuminuria and slow CKD progression in diabetic and non-diabetic patients.
  • RAAS inhibitors are recommended for hypertension in CKD patients with albuminuria, offering cardiovascular benefits beyond blood pressure reduction.
  • Use in non-proteinuric nephropathy and advanced CKD requires careful consideration, and double RAAS blockade is contraindicated. Dose titration and side effect management, particularly hyperkalemia, are critical.

Impact:

  • Provides guidance on optimal RAAS inhibitor therapy for CKD patients.
  • Emphasizes the importance of individualized treatment strategies to maximize benefits and minimize risks.
  • Informs clinical practice regarding the appropriate use of RAAS inhibitors in diverse CKD scenarios.

Keywords:
Chronic kidney diseaseEnfermedad renal crónicaNefropatíaNephropathyRenin angiotensin aldosterone systemSistema renina angiotensina aldosterona

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