Abstract:
:The first aldosterone blocker, spironolactone, initially was used as a diuretic but was accompanied by a significant amount of side effects that necessitated the withdrawal of the drug in a relevant number of patients. The discovery of the many receptor-mediated actions of aldosterone in several different organs greatly contributed to expand the indications of aldosterone blockers. Eplerenone was the second component of this class of drugs and differed from spironolactone because of its significantly better safety, albeit this was accompanied by a lower potency when used at equinumeric doses. Although these two drugs were being used in clinical practice, the epithelial sodium channel blockers, amiloride and triamterene, with a similar antialdosterone action, continued to be used in clinical practice in combination with thiazides and loop diuretics. New members of the third and fourth generation of mineralocorticoid receptor antagonists and aldosterone synthase inhibitors are in development. These new compounds, which include the new nonsteroidal mineralocorticoid-receptor antagonists and aldosterone synthase inhibitors, try to maintain adequate efficacy, avoiding the drawbacks of spironolactone and eplerenone. Ongoing studies will show the certainty of the capacities of these new compounds to override the virtues of the first mineralocorticoid-receptor spironolactone while avoiding the side effects leading so frequently to the withdrawal of the drug, including a significantly lower prevalence of hyperkalemia when chronic kidney disease is present.
journal_name
Semin Nephroljournal_title
Seminars in nephrologyauthors
Tamargo J,Solini A,Ruilope LMdoi
10.1016/j.semnephrol.2014.04.005subject
Has Abstractpub_date
2014-05-01 00:00:00pages
285-306issue
3eissn
0270-9295issn
1558-4488pii
S0270-9295(14)00047-3journal_volume
34pub_type
杂志文章,评审abstract::Toxic nephropathies cause acute and chronic renal failure, primarily as a result of injury to renal tubular epithelium. There is a well-known capacity in the renal nephron for the synchronous occurrence of both apoptosis and necrosis in toxic nephropathies. This has engendered interest in the differing or complementar...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/s0270-9295(03)00085-8
更新日期:2003-09-01 00:00:00
abstract::Apolipoprotein L1 (APOL1) genetic variants account for much of the excess risk of chronic and end-stage kidney disease, which results in a significant global health disparity for persons of African ancestry. We estimate the lifetime risk of kidney disease in APOL1 dual-risk allele individuals to be at least 15%. Exper...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2015.04.008
更新日期:2015-05-01 00:00:00
abstract::Cytomegalovirus (CMV), human herpes virus (HHV)-6, and HHV-7 are ubiquitous β-herpesviruses that can cause opportunistic infection and disease in kidney transplant recipients. Active CMV infection and disease are associated with acute allograft failure and death, and HHV-6 and HHV-7 replication are associated with CMV...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2016.05.012
更新日期:2016-09-01 00:00:00
abstract::Transforming growth factor-β (TGF-β) isoforms are profibrotic cytokines, par excellence, and have complex multifunctional effects on many systems, depending on the biologic setting. Retinoids are vitamin A derivatives that also have diverse effects in development, physiology, and disease. The interactions between thes...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2012.04.008
更新日期:2012-05-01 00:00:00
abstract::Substantial progress has been made in the application of computer-driven methods to provide erythropoietic dosing information for patients with anemia resulting from chronic kidney disease. Initial solutions were simply computerized versions of traditional paper-based anemia management protocols. True personalization ...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2018.05.010
更新日期:2018-07-01 00:00:00
abstract::Given the prohibitive costs of end-stage renal disease (ESRD) care for certain countries and the increasing incidence of ESRD worldwide, alternative methods of funding dialysis care are increasingly necessary. We describe the paradigm of the National Kidney Foundation of Singapore (NKF-S), the provider of subsidized d...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1053/snep.2001.23776
更新日期:2001-07-01 00:00:00
abstract::Premature menopause defined as secondary amenorrhea is common in women with kidney disease. Moreover, the aging population has resulted in increasing numbers of postmenopausal women with kidney disease. Though the pathophysiology is poorly understood, kidney transplantation and more frequent hemodialysis can restore m...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2017.05.013
更新日期:2017-07-01 00:00:00
abstract::The pathogenesis of many common etiologies of nephropathy has been informed by recent molecular genetic breakthroughs. It now is apparent that the ethnic disparity in the risk for nondiabetic chronic kidney disease between African Americans and European Americans is explained largely by variation in the apolipoprotein...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2017.07.006
更新日期:2017-11-01 00:00:00
abstract::Red cell production in chronic kidney disease is usually too low to maintain a normal haemoglobin, and thus anaemia develops in a large proportion of patients. The ability to stimulate erythropoiesis in the bone marrow by the use of therapeutic agents has only been possible in the last 20 years, initially with recombi...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2006.05.008
更新日期:2006-07-01 00:00:00
abstract::Compelling evidence points to a role for IgA receptors in the pathogenesis of IgA nephropathy. The soluble form of the type I IgA receptor (FcalphaRI or CD89) forms complexes with IgA that can be found in patients' serum and that initiate the disease in CD89 transgenic mice. A nonclassic IgA receptor, identified as th...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2007.10.010
更新日期:2008-01-01 00:00:00
abstract::Although systemic hypertension is a common clinical condition, hypertensive emergencies are distinctly unusual in clinical practice. There are some situations, however, that qualify as hypertensive emergencies or urgencies. It is important, therefore, to diagnose these conditions because immediate treatment of severe ...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2005.02.011
更新日期:2005-07-01 00:00:00
abstract::At the present time, knowledge of the structure of the proton-translocating ATPase responsible for urinary acidification is far from complete. Key issues awaiting resolution are full definition of subunit structure and an understanding of the interactions among functional domains of this complex hetero-oligomer. Such ...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:
更新日期:1990-03-01 00:00:00
abstract::One of the most important and lethal effects of animal venoms is nephrotoxicity. In Latin America, severe acute kidney injury has been reported after accidents with poisonous arthropods such as bees, caterpillars of the genus Lonomia, and spiders of the genus Loxosceles. In this article the characteristics of these ve...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2008.04.006
更新日期:2008-07-01 00:00:00
abstract::There are emerging data that the skeleton is connected to systemic biological functions through the release of two osteoblast-/osteocyte-derived hormones, fibroblastic growth factor 23 (FGF23) and undercarboxylated osteocalcin (Ocn). FGF23 is important in the regulation of phosphate and vitamin D metabolism, whereas O...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2012.12.014
更新日期:2013-03-01 00:00:00
abstract::Sonography has become integral to the evaluation and management of patients with renal disease. Although many of the procedures discussed in this issue are not feasible for all nephrologists, sonography clearly is. It is convenient and saves time, both for the physician and the patient, and the equipment is not expens...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1053/snep.2002.31712
更新日期:2002-05-01 00:00:00
abstract::Kidney disease has been shown to be highly prevalent in cancer patients in the IRMA studies (Renal Insufficiency and Anticancer Medications). Furthermore, anticancer drugs used in those patients, among which half have abnormal renal function, necessitate dosage adjustment in case of reduced renal function and/or is po...
journal_title:Seminars in nephrology
pub_type: 杂志文章
doi:10.1016/j.semnephrol.2010.09.003
更新日期:2010-11-01 00:00:00
abstract::Recent new insights into the determinants of the plasma water sodium concentration ([Na(+)](pw)) have played an important role in advancing our understanding of the pathogenesis and treatment of the dysnatremias. Central to these recent advances is the recognition of the full significance of the Edelman equation disco...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2009.03.006
更新日期:2009-05-01 00:00:00
abstract::Kidney function declines with age in association with the development of age-associated glomerulosclerosis. The well-established structural and functional changes with age are reviewed briefly. The modification of aging pathology by calorie restriction is discussed. The role of the podocyte as a critical cell in the a...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2009.07.012
更新日期:2009-11-01 00:00:00
abstract::Acute kidney injury (AKI) and chronic kidney disease (CKD) are interconnected syndromes that represent a global public health challenge. Organelles play essential roles in a vast range of cell functions, and their damage is related to several kidney diseases. Organelles launch the stress signal or trigger the stress r...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2019.10.007
更新日期:2019-11-01 00:00:00
abstract::Projected requirements for nephrology physicians indicate a need for an increase in the number of nephrology trainees. In addition, government regulations are creating the climate to diminish the entry of international medical graduates into all residency programs. To meet the needs of renal patients, especially those...
journal_title:Seminars in nephrology
pub_type: 杂志文章
doi:
更新日期:1999-03-01 00:00:00
abstract::Hypertension is growing in prevalence and most of this growth represents isolated systolic hypertension in the elderly. Attempts at prevention are critical but likely are ineffectual. Therefore, the delivery and acceptance of current medical regimens must be improved. ...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2005.02.002
更新日期:2005-07-01 00:00:00
abstract::Since the early 1960s, a number of new immunosuppressive agents have been introduced to clinical transplantation. This review will be confined to mechanism of actions, and important gains and concerns of new microemulsion formulation of cyclosporine A (Neoral), mycophenolate mofetil (MMF), FK506, brequinar sodium, sir...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:
更新日期:1997-07-01 00:00:00
abstract::Diabetes mellitus (DM) is becoming more common in the United States affecting an estimated 18.2 million Americans. Not only is the number of American's with DM staggering, but so are the medical and economic costs of DM. DM accounts for nearly 15% of all health care costs in the United States. The chronic hyperglycemi...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2005.09.009
更新日期:2006-03-01 00:00:00
abstract::Care of patients with type 1 diabetes (T1D) has changed during the past 30 years. Tools to control hyperglycemia have improved and it was shown that improvement in glycemic control diminished the risk of late diabetic complications, including nephropathy. Moreover, in patients with impaired renal function, aggressive ...
journal_title:Seminars in nephrology
pub_type: 杂志文章
doi:10.1016/j.semnephrol.2012.07.002
更新日期:2012-09-01 00:00:00
abstract::The Kidney Early Evaluation Program (KEEP) is a free, community-based, kidney disease screening program designed to detect chronic kidney disease (CKD) early and promote follow-up evaluation with clinicians to ultimately improve outcomes. This program screens individuals with diabetes, hypertension, or those with a fi...
journal_title:Seminars in nephrology
pub_type: 杂志文章
doi:10.1016/j.semnephrol.2009.10.004
更新日期:2010-01-01 00:00:00
abstract::Goodpasture (GP) syndrome is a form of anti-glomerular basement membrane (GBM) disease, in which autoantibodies bind to alpha3(IV) collagen in GBM causing rapidly progressive glomerulonephritis and pulmonary hemorrhage. The conformational GP epitopes have been mapped to 2 regions within the noncollagenous (NC1) domain...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1053/s0270-9295(03)00131-1
更新日期:2003-11-01 00:00:00
abstract::To characterize current evidence and current foci of perioperative clinical trials, we systematically reviewed Medline and identified perioperative trials involving 100 or more adult patients undergoing surgery and reporting renal end points that were published in high-impact journals since 2004. We categorized the 10...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2020.01.008
更新日期:2020-03-01 00:00:00
abstract::In contrast to managing patients on hemodialysis in whom iron strategies are more focused on intravenous iron, nondialysis chronic kidney disease (CKD) patients may receive either oral or intravenous iron. There are advantages and disadvantages for both strategies. Oral iron is simple and cheap to administer and does ...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2016.02.003
更新日期:2016-03-01 00:00:00
abstract::Dent's disease and familial hypomagnesemia with hypercalciuria and nephrocalcinosis (FHHNC) are inherited diseases in which hypercalciuria, nephrocalcinosis, and renal failure are prominent features. Dent's disease resembles a Fanconi syndrome, with impaired reabsorption in the proximal tubule; FHHNC, with urinary los...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1053/j.semnephrol.2003.08.011
更新日期:2004-01-01 00:00:00
abstract::Peritoneal dialysis (PD) may be a feasible, safe, and complementary alternative to hemodialysis not only in the chronic setting, but also in the acute setting. It previously was widely accepted for acute kidney injury (AKI) treatment, but its practice decreased in favor of other types of extracorporeal therapies. The ...
journal_title:Seminars in nephrology
pub_type: 杂志文章,评审
doi:10.1016/j.semnephrol.2016.10.011
更新日期:2017-01-01 00:00:00