Does blockade of the Renin-Angiotensin-aldosterone system slow progression of all forms of kidney disease?

Curr Hypertens Rep. 2010 Oct;12(5):369-77. doi: 10.1007/s11906-010-0142-2.

Abstract

The velocity of chronic kidney disease (CKD) progression is only partly dependent on the nature and activity of the underlying disease process. Activation of the renin-angiotensin-aldosterone system (RAAS) is a crucial, and often universal, event responsible for the pathophysiologic mechanisms that accelerate CKD progression. Thus, it would appear that interruption of the RAAS through the use of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, mineralocorticoid receptor antagonists, or direct renin inhibitors can play a principal role in slowing CKD progression, regardless of the cause. Unfortunately, applying this generalized approach to all forms of CKD has been delayed by the lack of strong, evidence-based data. The aim of this review is to provide the most current evidence available for the use of RAAS blockade as a method of slowing the progression of the various forms of CKD.

Publication types

  • Review

MeSH terms

  • Angiotensin Receptor Antagonists* / pharmacology
  • Angiotensin Receptor Antagonists* / therapeutic use
  • Angiotensin-Converting Enzyme Inhibitors* / pharmacology
  • Angiotensin-Converting Enzyme Inhibitors* / therapeutic use
  • Chronic Disease
  • Disease Progression
  • Humans
  • Kidney Diseases* / physiopathology
  • Kidney Diseases* / therapy
  • Kidney Diseases* / urine
  • Kidney Function Tests
  • Kidney Transplantation
  • Mineralocorticoid Receptor Antagonists* / pharmacology
  • Mineralocorticoid Receptor Antagonists* / therapeutic use
  • Proteinuria / drug therapy*
  • Randomized Controlled Trials as Topic
  • Renin-Angiotensin System / drug effects*
  • Renin-Angiotensin System / physiology

Substances

  • Angiotensin Receptor Antagonists
  • Angiotensin-Converting Enzyme Inhibitors
  • Mineralocorticoid Receptor Antagonists