慢性病中的RAS阻塞:当前的证据和未来的方向
Antonio Vitiello1, Annarita Ponzo2, Mariarosaria Boccellino3
1Department of Health Prevention, Research and Emergencies, Italian Ministry of Health, Rome, 00144, Italy.
Naunyn-Schmiedeberg's archives of pharmacology
|February 25, 2026
概括
雷宁-血管素系统 (RAS) 阻塞是慢性病 (CKD) 患者蛋白尿症的基础疗法. 它减少了损伤,并与更新的药物如SGLT2抑制剂一起工作,以获得更好的结果.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學.
- 药理学 药理学是指药理学的学科.
- 心血管医学 心血管医学
背景情况:
- 慢性病 (CKD) 是一个重要的全球健康问题,有多种原因,如糖尿病和高血压.
- 这些情况往往导致类似的有害结果,包括损伤和蛋白尿.
研究的目的:
- 审查-血管素系统 (RAS) 修饰剂在患有病和显著蛋白尿症的患者中的作用.
- 分析RAS阻塞对白蛋白尿,蛋白尿,功能和疾病进展的影响.
主要方法:
- 对CKD中RAS抑制的临床证据和生物学理由的审查.
- 检查当前的治疗场景,包括与SGLT2抑制剂等药物的联合疗法.
主要成果:
- 阻断RAS可以减少白蛋白尿和白蛋白尿,稳定功能,减缓CKD的进展.
- 抑制RAS降低了脑膜内压力,并减轻了损伤.
- 优化剂量,电解质监测和并发症管理对于最大限度地获得益处至关重要.
结论:
- RAS阻塞是蛋白尿性CKD的基石疗法,提供心血管保护和减少蛋白尿.
- 未来的策略包括优化组合疗法,精确的患者选择,并整合新的药理途径,以增强脏保护.
相关概念视频
Chronic Kidney Disease III: Interprofessional Care
529
Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
529
Acute Kidney Injury IV: Diagnostic Studies and Prevention
387
Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
387
Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
1.3K
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
1.3K
Chronic Kidney Disease I: Introduction
863
Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
863
Chronic Kidney Disease IV: Nursing Management
476
Nursing management is essential for preventing complications, maintaining stability, and improving patients' quality of life in chronic kidney disease (CKD). By using a structured approach, nurses help slow CKD progression and support effective patient care.1. Comprehensive patient assessmentEffective management begins with nurses reviewing the patient’s medical history, and identifying key risk factors like diabetes, hypertension, and nephrotoxic drug use. Nurses assess signs of...
476
Antihypertensive Drugs: Direct Renin Inhibitors
1.6K
The renin-angiotensin-aldosterone system (RAAS) is an intricate physiological pathway involving numerous enzymes and hormones, including renin, angiotensin-converting enzyme (ACE), angiotensin I and II, and aldosterone. Imbalances within this system increase the production of angiotensin II and aldosterone. Increased angiotensin II levels promote vasoconstriction and blood pressure elevation. Concurrently, higher aldosterone levels stimulate sodium and water reabsorption in the kidneys,...
1.6K


