What is the role of renin inhibition in the treatment of diabetic kidney disease?

Abstract:

:Inhibition of the renin-angiotensin-aldosterone system (RAAS) plays a pivotal role in preventing and treating diabetic nephropathy. However, despite documented beneficial effects of RAAS inhibitors in diabetic patients with nephropathy, reversal of the progressive course of this disorder or at least long-term stabilization of renal function are often difficult to achieve, and many patients still progress to end-stage renal disease. Incomplete inhibition of the RAAS has been postulated as one of the reasons for unsatisfactory therapeutic responses to RAAS inhibition in some patients. Inhibition of renin, a rate-limiting step in the RAAS activation cascade, is the logical approach to overcome at least some of the above-mentioned problems associated with the treatment with traditional RAAS inhibitors. This article focuses on experimental and clinical studies evaluating the two principal approaches to renin inhibition: direct renin inhibition with competitive inhibitors (eg, aliskiren) and inhibition of the (pro)renin receptor.

journal_name

Curr Diab Rep

journal_title

Current diabetes reports

authors

Komers R

doi

10.1007/s11892-009-0073-y

subject

Has Abstract

pub_date

2009-12-01 00:00:00

pages

447-52

issue

6

eissn

1534-4827

issn

1539-0829

journal_volume

9

pub_type

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