Abstract：
:Diabetic kidney disease (DKD) affects approximately one-third of patients with diabetes and taking into consideration the high cardiovascular risk burden associated to this condition a multifactorial therapeutic approach is traditionally recommended, in which glucose and blood pressure control play a central role. The inhibition of renin-angiotensin-aldosterone RAAS system represent traditionally the cornerstone of DKD. Clinical outcome trials have demonstrated clinical significant benefit in slowing nephropathy progression mainly in the presence of albuminuria. Thus, international guidelines mandate their use in such patients. Given the central role of RAAS activity in the pathogenesis and progression of renal and cardiovascular damage, a more profound inhibition of the system by the use of multiple agents has been proposed in the past, especially in the presence of proteinuria, however clinical trials have failed to confirm the usefulness of this therapeutic approach. Furthermore, whether strict blood pressure control and pharmacologic RAAS inhibition entails a favorable renal outcome in non-albuminuric patients is at present unclear. This aspect is becoming an important issue in the management of DKD since nonalbuminuric DKD is currently the prevailing presenting phenotype. For these reasons it would be advisable that blood pressure management should be tailored in each subject on the basis of the renal phenotype as well as related comorbidities. This article reviews the current literature and discusses potentials and limitation of targeting the RAAS in order to provide the greatest renal protection in DKD.
journal_name
J Nephroljournal_title
Journal of nephrologyauthors
Leoncini G,Viazzi F,De Cosmo S,Russo G,Fioretto P,Pontremoli Rdoi
10.1007/s40620-020-00803-3subject
Has Abstractpub_date
2020-10-01 00:00:00pages
949-963issue
5eissn
1121-8428issn
1724-6059pii
10.1007/s40620-020-00803-3journal_volume
33pub_type
杂志文章,评审abstract：BACKGROUND:Different mitogens are involved in the pathogenesis of kidney damage after subtotal nephrectomy. One of them, TGF-beta, controls mesangial cell proliferation and interstitial fibrosclerosis. The transduction of the TGF-beta signal is controlled by intracellular signalling molecules such as Ras G monomeric pr...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：
更新日期：2002-09-01 00:00:00
abstract：OBJECTIVE:Intradialytic exercise (IDE) is not yet a routine practice for hemodialysis patients, the lack of guidelines supporting it being a major reason. This systematic review and meta-analysis of aerobic IDE interventions examined the efficacy of IDE regarding quality of life (QOL), serum phosphorus, dialysis effici...
journal_title：Journal of nephrology
pub_type： 杂志文章,meta分析
doi：10.1007/s40620-018-00565-z
更新日期：2019-08-01 00:00:00
abstract：BACKGROUND:Inadvertent sodium (Na(+)) flux may occur during renal replacement therapy (RRT) in ICU. The objective of this study was to estimate sodium flux during RRT. METHODS:Between September 2011 to December 2012 we studied 60 ICU patients receiving extended daily dialysis (EDD, Fresenius 4008S) or continuous renal...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：10.1007/s40620-014-0041-8
更新日期：2014-08-01 00:00:00
abstract：OBJECTIVE:To investigate the pregnancy outcomes for patients with stage 3-4 chronic kidney disease (CKD) and the effects of pregnancy on kidney function. METHODS:Clinical data of pregnant women with CKD in the Peking University First Hospital between January 1st 2005 and October 1st 2016 were retrospectively analysed....
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：10.1007/s40620-018-0509-z
更新日期：2018-12-01 00:00:00
abstract：:Membranous glomerulopathy (MGN) is a frequent cause for nephrotic syndrome in adults. In this overview, the basic pathogenic features of Heymann nephritis, a "classical" model of MGN in rats, are compared with those of human MGN. While the pathogenic antigen(s) of rat Heymann nephritis (the polyspecific receptor prote...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：
更新日期：2000-11-01 00:00:00
abstract：BACKGROUND:This study is part of a 3-country study testing whether normal levels of hemoglobin (Hgb) delay the progression of left ventricular (LV) growth in chronic kidney disease (CKD) patients not on dialysis. METHODS:This was an open-label, randomized, multicenter, controlled trial conducted in 27 tertiary-care ho...
journal_title：Journal of nephrology
pub_type： 杂志文章,多中心研究,随机对照试验
doi：
更新日期：2008-11-01 00:00:00
abstract：:Diabetic nephropathy (DN) is a common complication of Diabetes Mellitus (DM) Types 1 and 2, and prevention of end stage renal disease (ESRD) remains a major challenge. Despite its high prevalence, the pathogenesis of DN is still controversial. Initial glomerular disease manifested by hyperfiltration and loss of glomer...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：10.1007/s40620-017-0423-9
更新日期：2017-12-01 00:00:00
abstract：BACKGROUND:We tested the hypothesis that the universal application of myocardial scanning with single-photon emission computed tomography (SPECT) would result in better risk stratification in renal transplant candidates (RTC) compared with SPECT being restricted to patients who, in addition to renal disease, had other ...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：
更新日期：2010-05-01 00:00:00
abstract：:Colchicine is an effective antiinflammatory medication. It should be used with great caution, however, in patients requiring dialysis. Coadministration of colchicine and macrolides may impair colchicine elimination, resulting in excess drug exposure and toxicity. We report 2 renal failure cases of colchicine intoxicat...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：
更新日期：2006-07-01 00:00:00
abstract：BACKGROUND:The risks connected with dialysis fluid contamination are well established. Epidemiological studies have demonstrated just how difficult it is to obtain permanently satisfactory quality standards. Therefore, dialysis centers must have effective and regular quality control programs, particularly with the grow...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：
更新日期：2004-07-01 00:00:00
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journal_title：Journal of nephrology
pub_type： 杂志文章,随机对照试验
doi：10.5301/jn.2011.6252
更新日期：2011-03-01 00:00:00
abstract：:Membranous nephropathy (MN) is a glomerular disease characterized by proteinuria, usually in a nephrotic range, and variable natural course. The etiology is unknown in many cases, while in some patients, MN may be secondary to infection, to other diseases, or to exposure to drugs and toxic substances. In idiopathic MN...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：
更新日期：2007-05-01 00:00:00
abstract：:Structural and functional alterations affecting the aging kidney predispose to an increased risk of acute renal failure (ARF) in the elderly. This is a common problem becoming more relevant because of an increase in life expectancy. The epidemiology of ARF in the elderly is far from being well assessed, because of the...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：10.5301/jn.5000141
更新日期：2012-01-01 00:00:00
abstract：BACKGROUND:Chronotropic incompetence (CI) is an independent predictor of cardiovascular events and overall mortality. The prevalence and significance of CI in renal transplant patient has not been examined. METHODS:38 non-heart failure renal transplant recipients were recruited for a transthoracic echocardiogram and t...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：10.1007/s40620-014-0091-y
更新日期：2014-08-01 00:00:00
abstract：:Sclerosing encapsulating peritonitis (SEP) is a serious complication of long-term continuous ambulatory peritoneal dialysis (CAPD), very likely related to a persisting expression of the transforming growth factor beta1 (TGFbeta1) gene on peritoneal mesothelial cells. We report the case of a 67-year-old uremic woman wh...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：
更新日期：1999-11-01 00:00:00
abstract：BACKGROUND:The therapeutic effects of immunosuppressive agents such as cyclosporin A, mycophenolate mofetil, rituximab and sirolimus on primary focal segmental glomerulosclerosis (FSGS) remain controversial. The present study was intended to review and analyze the treatment results of immunosuppressive agents for prima...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：10.5301/jn.5000092
更新日期：2012-09-01 00:00:00
abstract：:Preemptive isolated liver transplantation (PLTX) can cure the metabolic defect in primary hyperoxaluria type 1 (PH1) but there are no uniformally accepted recommendations concerning the timing of this transplantation procedure. We have performed PLTX successfully in 4 children (age 3-9 years) with PH1 with no mortalit...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：
更新日期：1998-03-01 00:00:00
abstract：:The pathophysiological mechanisms underlying preeclampsia, a serious complication of pregnancy, are largely unknown. Since, on the other hand, the various risk factors are known, primary and secondary prevention with pre- and inter-pregnancy counseling should be undertaken, and a follow-up should be conducted to evalu...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：
更新日期：2008-09-01 00:00:00
abstract：BACKGROUND:In biopsy-proven idiopathic nephrotic syndrome (INS), immunoglobulin M (IgM) and C1q are occasionally deposited in the mesangium. In pediatric nephrology, the significance of mesangial IgM or C1q deposits is controversial, based on previous reports. The aim of this study was to explore the clinical significa...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：10.5301/jn.5000133
更新日期：2013-03-01 00:00:00
abstract：BACKGROUND AND AIMS:It has been well documented that gene and DNA alterations occur frequently in benign primary parathyroid adenomas as well as in parathyroid glands with secondary hyperplasia. However, it has not been shown whether a correlation exists between somatic DNA aberrations and clinical data. METHODS:We an...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：
更新日期：2007-03-01 00:00:00
abstract：:Thales was born into a noble family of Phoenician origin at the time of the 25th Olympiad (floruit 585 bc; he was 40 in the year of the solar eclipse. He had no teachers but had occasion to learn from Egyptian priests. He developed into a scholar and politician very much appreciated by Heraclitus, Herodotus and Democr...
journal_title：Journal of nephrology
pub_type： 传,历史文章,杂志文章
doi：
更新日期：2009-11-01 00:00:00
abstract：:Sudden cardiac death (SCD) is a major cause of concern in end stage renal disease (ESRD), contributing to 70% of cardiovascular mortality and 27% of all-cause mortality in dialysis patients. Yet its mechanisms and pathogenesis remain largely obscure. This review discusses the potential reasons for an exaggerated risk ...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：10.1007/s40620-014-0151-3
更新日期：2015-04-01 00:00:00
abstract：:The hallmark of IgA nephropathy (IgAN) is macroscopic hematuria coinciding with, or immediately following, a mucosal infection, usually of the upper respiratory airways. The role of mucosal pathogens has been proven in different experimental models. Mucosal (or innate) immunity acts through the recognition of pathogen...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：
更新日期：2010-11-01 00:00:00
abstract：BACKGROUND:Reset osmostat (RO) occurs in 36% of patients with syndrome of inappropriate antidiuretic hormone secretion (SIADH) and is not often considered when evaluating hyponatremic patients. Patients with RO are not usually treated, but recent awareness that symptoms are associated with mild hyponatremia creates a t...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：10.5301/jn.5000074
更新日期：2012-09-01 00:00:00
abstract：:Emphysematous pyelonephritis is a rare life-threatening infection of the renal parenchyma. It usually affects unilateral kidney and occurs mostly in diabetic patients. It is characterized by the presence of gas within the renal parenchyma and requires prompt diagnosis and early aggressive therapy. Bilateral emphysemat...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：
更新日期：2000-03-01 00:00:00
abstract：:IgA nephropathy (IgAN) is characterised by the mesangial deposition of polymeric IgA1 (pIgA1). pIgA1 production is reduced in the mucosal immune system in IgAN and increased in the marrow; this switch may be secondary to a defect in gammadeltaT cell control of IgA production. However this does not explain the mechanis...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：
更新日期：1999-03-01 00:00:00
abstract：:In the general population, moderate exercise is associated with several health benefits including a decreased risk of obesity, coronary heart disease, stroke, certain types of cancer and all-cause mortality. In chronic kidney disease (CKD), physical inability is an independent risk of death. Health benefits of regular...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：10.1007/s40620-014-0169-6
更新日期：2015-04-01 00:00:00
abstract：:The management of rapidly progressive glomerulonephritis has been transformed over the past thirty years. It has become one of the few forms of glomerulonephritis that can be effectively treated, and today overall renal survival is as high as 70%. Effective management of patients with RPGN requires prompt and accurate...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：
更新日期：1999-07-01 00:00:00
abstract：BACKGROUND:Targeted screening interventions for chronic kidney disease (CKD) are increasingly being implemented in various community settings. However, the overall success of these programs is uncertain. Therefore, the aim of this review is to determine whether targeted screening is effective in detecting people with u...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：10.1007/s40620-017-0375-0
更新日期：2018-02-01 00:00:00
abstract：BACKGROUND:Pericardial effusion in uremic patients (UPE) was first described by R. Bright in 1836. It is generally agreed that patients require emergency pericardial drainage when tamponade signs are present, but in patients with no tamponade the optimal timing for drainage remains unclear. METHODS:To define patients ...
journal_title：Journal of nephrology
pub_type： 杂志文章
doi：10.1007/s40620-014-0107-7
更新日期：2015-02-01 00:00:00
