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Nihon Rinsho. 2012 Sep;70(9):1562-70.

[Cardio-renal interactions].

[Article in Japanese]

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Division of Nephrology, Endocrinology and Vascular Medicine, Department of Medicine, Tohoku University School of Medicine.


The renin-angiotensin-aldosterone system (RAAS) plays a crucial role in pathophysiology of kidney and cardiovascular disease, and their interactions. Clinical studies have demonstrated that RAAS inhibition reduces cardiovascular and renal events, particularly in patients with renal dysfunction. It may be assumed that impairment of renal function induces various injurious substances such as inflammation and oxidative molecules, which may activate RAAS, and RAAS, in turn, enhances inflammations and oxidative stress. Studies have shown that indices of renal protection, such as reductions of albuminuria, are closely associated with cardiovascular protection. In addition, decrements of renal function are also associated with worse prognosis. Inhibitors of RAAS decrease urinary albumin excretion but also reduce GFR. From the clinical point of view, the most appropriate antihypertensive regime would be the one that reduces albuminuria but maintain GFR.

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