Abstract:
PURPOSE OF THIS REVIEW:The purpose of this review is to explain the rationale and limitations for use of mineralocorticoid receptor blockers (MRBs) for the treatment of chronic kidney disease (CKD) and its complications. RECENT FINDINGS:Recent studies in animal models of CKD demonstrate that blockade of the mineralocorticoid receptor using spironolactone or eplerenone decreases inflammation, oxidative stress, proteinuria and glomerular and tubular injury. Patients with CKD are at very high risk for progression of kidney disease and major cardiovascular events. Recent studies in patients with CKD demonstrate that administration of low doses of MRBs added onto an angiotensin-converting enzyme inhibitor-based regimen reduces proteinuria--a risk marker for both progressive kidney disease and cardiovascular events. However, incident hyperkalemia, an unwanted side effect, dampened enthusiasm for this approach. There are no large-scale, long-term outcome trials examining whether MRB can slow progression of kidney disease or prevent cardiovascular events. SUMMARY:At this time it is unknown whether mineralocorticoid receptor blockade can improve outcomes in patients with CKD. To move this field forward and determine whether these agents can improve the lives of patients with kidney disease, novel strategies to prevent or ameliorate hyperkalemia are needed.
journal_name
Curr Opin Nephrol Hypertensjournal_title
Current opinion in nephrology and hypertensionauthors
Toto RDdoi
10.1097/MNH.0b013e32833ce6d5subject
Has Abstractpub_date
2010-09-01 00:00:00pages
444-9issue
5eissn
1062-4821issn
1473-6543journal_volume
19pub_type
杂志文章,评审abstract:PURPOSE OF REVIEW:Non-valvular atrial fibrillation is common in patients with severe chronic kidney disease (CKD) and historically patients have been treated with vitamin K antagonists (VKA). However, these agents have questionable efficacy and are associated with increased bleeding risk. Non-vitamin K oral anticoagula...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0000000000000443
更新日期:2018-11-01 00:00:00
abstract:PURPOSE OF REVIEW:The review will examine clinically relevant advances in the area of polycystic kidney disease (PKD), mainly focusing on autosomal dominant polycystic kidney disease (ADPKD). Discussion will focus on predicting the course of ADPKD, clinical trials and new research endeavors. RECENT FINDINGS:During the...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0b013e32835011a7
更新日期:2012-03-01 00:00:00
abstract::There has been an increasing focus on renovascular disease, particularly in renal failure, and on the role of renal angioplasty and stenting. Significant improvements have occurred in non-invasive imaging techniques. This review concentrates on the recent developments in imaging that specifically targets the renal art...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-200211000-00011
更新日期:2002-11-01 00:00:00
abstract:PURPOSE OF REVIEW:Peroxisome proliferator-activated receptor gamma (PPARγ) is a ligand-activated nuclear transcription factor that regulates many important physiological processes including glucose and lipid metabolism, energy homeostasis, cell proliferation, inflammation, immunity and reproduction. The current review ...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0b013e32834de526
更新日期:2012-01-01 00:00:00
abstract:PURPOSE OF REVIEW:Both cognitive and physical function are commonly impaired in individuals with chronic kidney disease (CKD), resulting in important impacts on their quality of life and overall health. This review summarizes the burden of cognitive and physical impairment in CKD, focusing on recent research that highl...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/01.mnh.0000444821.87873.7b
更新日期:2014-05-01 00:00:00
abstract:PURPOSE OF REVIEW:This review surveys the literature on the search for the genetic basis of hypertension during the 10 months since November 2003. The goals set forth by this search are defined and the highlights of the work accomplished are provided. RECENT FINDINGS:The search for the genetic basis of hypertension is...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-200503000-00009
更新日期:2005-03-01 00:00:00
abstract:PURPOSE OF REVIEW:Nox-4 is a member of the NADPH oxidase (Nox) family of enzymes implicated in reactive oxygen species generation. Nox-4 is distributed in many tissues; however, its physiological functions remain poorly understood. In contrast to other Nox isoforms, it is unique in that it produces large amounts of hyd...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0000000000000082
更新日期:2015-01-01 00:00:00
abstract:PURPOSE OF REVIEW:MRI can noninvasively assess the structure and function of the kidney in a single MRI scan session. This review summarizes recent advancements in functional renal MRI techniques, with a particular focus on clinical applications. RECENT FINDINGS:A number of MRI techniques now provide measures of relev...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0000000000000266
更新日期:2016-11-01 00:00:00
abstract:PURPOSE OF REVIEW:This review focuses on recent efforts in identifying with-no-lysine kinase 4 (WNK4) as a physiological intracellular chloride sensor and exploring regulators of intracellular chloride concentration ([Cl-]i) in the distal convoluted tubule (DCT). RECENT FINDINGS:The discovery of WNK1's chloride-bindin...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章
doi:10.1097/MNH.0000000000000683
更新日期:2021-03-01 00:00:00
abstract::Overexpression of the cytokine transforming growth factor-beta has been identified as the key mediator of chronic progressive kidney fibrosis in experimental and human kidney diseases. The renoprotective effects of angiotensin II blockade and low-protein diets have recently been linked to downregulation of transformin...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-199707000-00014
更新日期:1997-07-01 00:00:00
abstract:PURPOSE OF REVIEW:To characterize the mechanism and clinical impact of the angiotensin-receptor blocker losartan on both renal uric acid handling and thereby serum uric acid. RECENT FINDINGS:Losartan effect on serum uric acid has been demonstrated at various stages of renal failure including most recently observations...
journal_title:Current opinion in nephrology and hypertension
pub_type: 社论,评审
doi:10.1097/00041552-200209000-00001
更新日期:2002-09-01 00:00:00
abstract:PURPOSE OF REVIEW:Calcium is an essential ion for the maintenance of normal bone health and physiologic functions. The extracellular and intracellular levels of calcium are maintained through hormonal regulation called homeostasis. Balance, the net intake minus excretion of calcium, is maintained by hormonal regulation...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0000000000000416
更新日期:2018-07-01 00:00:00
abstract::Cells in renal medullas are exposed to a high concentration of salt during antidiuresis. They adapt in part by accumulating myo-inositol, glycine betaine, taurine, and other amino acids by transporting them from the interstitial fluid. This transport is osmotically regulated by changes in transcription of the transpor...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-199709000-00004
更新日期:1997-09-01 00:00:00
abstract::It has been 6 years since the first reports of the use of recombinant human erythropoietin for the treatment of renal anemia appeared in the medical literature. During this period, erythropoietin has become established as a safe and highly effective therapy, and it is currently being evaluated for other nonrenal types...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-199212000-00005
更新日期:1992-12-01 00:00:00
abstract:PURPOSE OF REVIEW:Sirtuins are a family of nicotinamide adenine dinucleotide+-dependent enzymes catalyzing target protein deacetylation to modulate cellular metabolism, response to oxidative stress and inflammation, senescence, autophagy and apoptosis. In this review, we provide an overview of recent studies regarding ...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章
doi:10.1097/MNH.0000000000000660
更新日期:2021-01-01 00:00:00
abstract:PURPOSE OF REVIEW:Peroxisome proliferator-activated receptors (PPARs) are a family of nuclear receptors activated by nutrient molecules and their derivatives. Their role has been increasingly recognized to be important in hypertension, metabolic disorders and cardiovascular disease, including atherosclerosis. Control o...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0b013e328325803b
更新日期:2009-03-01 00:00:00
abstract:PURPOSE OF REVIEW:Insulin resistance is a known complication of end-stage renal disease that also appears to be present in earlier stages of chronic kidney disease (CKD). It is a risk factor for cardiovascular disease and an important potential therapeutic target in this population. Measurement of insulin resistance is...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0b013e32834b23c1
更新日期:2011-11-01 00:00:00
abstract:PURPOSE OF REVIEW:To summarize the latest information on body composition among patients with chronic kidney disease and its association with outcomes. RECENT FINDINGS:Obesity is increasing among patients with end-stage renal disease and is more prevalent when direct measures of adiposity are used rather than BMI. Hig...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0000000000000120
更新日期:2015-05-01 00:00:00
abstract:PURPOSE OF REVIEW:To discuss if there will still be a role for the originator ESAs after the already available biosimilars and the approval of HIF stabilizers in the near future. RECENT FINDINGS:Current treatment with erythropoiesis-simulating agents (ESAs) is effective and generally well tolerated, but requires paren...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0000000000000432
更新日期:2018-09-01 00:00:00
abstract:PURPOSE OF REVIEW:In light of the recent changes to the kidney allocation system (KAS) and the observed increase in the rate of transplantation of the highly sensitized kidney transplant candidate, the evaluation and care of this population is a timely topic. RECENT FINDINGS:In its first year, the new KAS has already ...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0000000000000172
更新日期:2015-11-01 00:00:00
abstract:PURPOSE OF REVIEW:The renin-angiotensin system plays an important role in cardiovascular disease via the production of angiotensin II. Over the past decades, however, more and more evidence has accumulated suggesting an important role for another angiotensin: Angiotensin-(1-7) [Ang-(1-7)]. In this review, we discuss th...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0000000000000050
更新日期:2014-09-01 00:00:00
abstract::It has been suspected that abnormalities of the L-arginine-nitric oxide pathway could underlie certain forms of hypertension. In this review, we will consider the role of nitric oxide in primary and secondary models of experimental hypertension and discuss potential abnormalities of the L-arginine-nitric oxide pathway...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-199503000-00012
更新日期:1995-03-01 00:00:00
abstract::Growth hormone and a number of polypeptide growth factors exert actions on renal development, growth, and metabolism and on repair processes following renal injury. There is increasing evidence that under selected circumstances, these agents play roles in the pathogenesis of kidney disease and that under others, they ...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-199301000-00010
更新日期:1993-01-01 00:00:00
abstract::There is substantial evidence to suggest that regular physical activity reduces the risk of heart disease. Less clear is the extent to which this is caused by blood pressure reduction. This review considers effects of exercise on blood pressure and overall cardiovascular risk in normotensive and hypertensive individua...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-199505000-00008
更新日期:1995-05-01 00:00:00
abstract:PURPOSE OF REVIEW:Phosphate homeostasis is tightly controlled by the coordinated activity of bone, kidney, intestine, and parathyroid gland. The renal phosphate transporters have emerged as key regulators of both total body phosphate homeostasis and serum phosphate concentration. This review focuses on the latest updat...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0000000000000053
更新日期:2014-09-01 00:00:00
abstract:PURPOSE OF REVIEW:Hypertension (HTN) and chronic kidney disease (CKD) are significant problems. With recent advances in technologies, biosensors have shown a great potential to provide better home monitoring in hypertension (HTN), medication compliance, diagnostic device for kidney disease, CKD/end-stage renal disease ...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0000000000000517
更新日期:2019-07-01 00:00:00
abstract::The L-arginine: nitric oxide pathway is widely recognized as an important regulator of cell function and communication in a variety of physiological and pathophysiological situations. Recent advances in the biochemistry and molecular biology of nitric oxide synthases have contributed significantly to our understanding...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-199301000-00018
更新日期:1993-01-01 00:00:00
abstract:PURPOSE OF REVIEW:Assessment of fluid status to reach normovolemia in patients with chronic kidney disease (CKD) continues to be a tough task. Besides clinical observation, technological methods have been introduced, yet, the best approach is still uncertain. The present review looks at fluid overload in CKD from three...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章
doi:10.1097/MNH.0000000000000640
更新日期:2020-11-01 00:00:00
abstract::Our basic understanding of sodium mechanisms provides unique insights into epithelial transport processes, and unusual clinical syndromes can arise from mutations of these ion transporters. These genetic disorders affect sodium balance, with both sodium-retaining and sodium-wasting conditions being the consequence. A ...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/00041552-200107000-00003
更新日期:2001-07-01 00:00:00
abstract:PURPOSE OF REVIEW:Glucose 6-phosphate dehydrogenase (G6PD) is the rate-limiting enzyme of the pentose phosphate pathway. G6PD is the main source of the essential cellular reductant, NADPH. The purpose of this review is to describe the biochemistry of G6PD and NADPH, cellular factors that regulate G6PD, normal physiolog...
journal_title:Current opinion in nephrology and hypertension
pub_type: 杂志文章,评审
doi:10.1097/MNH.0000000000000294
更新日期:2017-01-01 00:00:00