Angiotensin Type 1 Receptor Blockers in Chronic Kidney Disease

2004 ◽  
pp. 159-166 ◽  
Author(s):  
H. Suzuki
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Receptor Blockers ◽  
Angiotensin Type

scholarly journals Angiotensin type 2 receptor actions contribute to angiotensin type 1 receptor blocker effects on kidney fibrosis

2010 ◽  
Vol 298 (3) ◽  
pp. F683-F691 ◽  
Author(s):  
Takashi Naito ◽  
Li-Jun Ma ◽  
Haichun Yang ◽  
Yiqin Zuo ◽  
Yiwei Tang ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Angiotensin Ii ◽  
Kidney Disease ◽  
Receptor Antagonist ◽  
Plasminogen Activator ◽  
Plasminogen Activator Inhibitor ◽  
Plasminogen Activator Inhibitor 1 ◽  
Activator Inhibitor ◽  
Angiotensin Type

Angiotensin type 1 (AT1) receptor blocker (ARB) ameliorates progression of chronic kidney disease. Whether this protection is due solely to blockade of AT1, or whether diversion of angiotensin II from the AT1 to the available AT2 receptor, thus potentially enhancing AT2 receptor effects, is not known. We therefore investigated the role of AT2 receptor in ARB-induced treatment effects in chronic kidney disease. Adult rats underwent 5/6 nephrectomy. Glomerulosclerosis was assessed by renal biopsy 8 wk later, and rats were divided into four groups with equivalent glomerulosclerosis: no further treatment, ARB, AT2 receptor antagonist, or combination. By week 12 after nephrectomy, systolic blood pressure was decreased in all treatment groups, but proteinuria was decreased only with ARB. Glomerulosclerosis increased significantly in AT2 receptor antagonist vs. ARB. Kidney cortical collagen content was decreased in ARB, but increased in untreated 5/6 nephrectomy, AT2 receptor antagonist, and combined groups. Glomerular cell proliferation increased in both untreated 5/6 nephrectomy and AT2 receptor antagonist vs. ARB, and phospho-Erk2 was increased by AT2 receptor antagonist. Plasminogen activator inhibitor-1 mRNA and protein were increased at 12 wk by AT2 receptor antagonist in contrast to decrease with ARB. Podocyte injury is a key component of glomerulosclerosis. We therefore assessed effects of AT1 vs. AT2 blockade on podocytes and interaction with plasminogen activator inhibitor-1. Cultured wild-type podocytes, but not plasminogen activator inhibitor-1 knockout, responded to angiotensin II with increased collagen, an effect that was completely blocked by ARB with lesser effect of AT2 receptor antagonist. We conclude that the benefical effects on glomerular injury achieved with ARB are contributed to not only by blockade of the AT1 receptor, but also by increasing angiotensin effects transduced through the AT2 receptor.

1621-P: Period Prevalence of Chronic Kidney Disease and Obesity in Adults with Type 1 Diabetes

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 1621-P
Author(s):  
AMELIA WALLACE ◽  
ALEX R. CHANG ◽  
MORGAN GRAMS ◽  
ELIZABETH SELVIN
Keyword(s):  
Chronic Kidney Disease ◽  
Type 1 Diabetes ◽  
Kidney Disease ◽  
Period Prevalence

scholarly journals Guidelines adherence in the prevention and management of chronic kidney disease in patients with diabetes mellitus on the background of recent European recommendations – a registry-based analysis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Peter Bramlage ◽  
Stefanie Lanzinger ◽  
Sascha R. Tittel ◽  
Eva Hess ◽  
Simon Fahrner ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Chronic Kidney Disease ◽  
Clinical Practice ◽  
Kidney Disease ◽  
Analysis Data ◽  
Disease Diagnosis ◽  
Diabetic Patients ◽  
European Society Of Cardiology

Abstract Background Recent European Society of Cardiology (ESC)/European Association for the Study of Diabetes (EASD) guidelines provide recommendations for detecting and treating chronic kidney disease (CKD) in diabetic patients. We compared clinical practice with guidelines to determine areas for improvement. Methods German database analysis of 675,628 patients with type 1 or type 2 diabetes, with 134,395 included in this analysis. Data were compared with ESC/EASD recommendations. Results This analysis included 17,649 and 116,747 patients with type 1 and type 2 diabetes, respectively. The analysis showed that 44.1 and 49.1 % patients with type 1 and type 2 diabetes, respectively, were annually screened for CKD. Despite anti-diabetic treatment, only 27.2 % patients with type 1 and 43.5 % patients with type 2 achieved a target HbA1c of < 7.0 %. Use of sodium-glucose transport protein 2 inhibitors (1.5 % type 1/8.7 % type 2 diabetes) and glucagon-like peptide-1 receptor agonists (0.6 % type 1/5.2 % type 2 diabetes) was limited. Hypertension was controlled according to guidelines in 41.1 and 67.7 % patients aged 18–65 years with type 1 and 2 diabetes, respectively, (62.4 vs. 68.4 % in patients > 65 years). Renin angiotensin aldosterone inhibitors were used in 24.0 and 40.9 % patients with type 1 diabetes (micro- vs. macroalbuminuria) and 39.9 and 47.7 %, respectively, in type 2 diabetes. Conclusions Data indicate there is room for improvement in caring for diabetic patients with respect to renal disease diagnosis and treatment. While specific and potentially clinically justified reasons for non-compliance exist, the data may serve well for a critical appraisal of clinical practice decisions.

455-P: Global Comparisons of Awareness of Chronic Kidney Disease and Renoprotective Therapies among Type 1 Diabetes Patients

Diabetes ◽  
2021 ◽  
Vol 70 (Supplement 1) ◽  
pp. 455-P
Author(s):  
EMILY YE ◽  
JULIA STEVENSON ◽  
JACQUELINE TAIT ◽  
REBECCA GOWEN ◽  
SARA SUHL ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Type 1 Diabetes ◽  
Kidney Disease ◽  
Diabetes Patients

scholarly journals Nephroprotective strategy in the treatment of hypertension as a modern general medical problem

2018 ◽  
pp. 107-118 ◽  
Author(s):  
V. I. Podzolkov ◽  
A. E. Bragina ◽  
T. I. Ishina ◽  
L. V. Bragina ◽  
L. V. Vasilyeva
Keyword(s):  
Chronic Kidney Disease ◽  
Angiotensin Ii ◽  
Kidney Disease ◽  
Renal Dysfunction ◽  
Medical Problem ◽  
Angiotensin Ii Receptor Blocker ◽  
Angiotensin Ii Receptor ◽  
High Prevalence ◽  
Advanced Stages ◽  
Receptor Blockers

The current population is characterized by a high prevalence of risk factors for the development of chronic kidney disease: hypertension, diabetes, obesity, metabolic syndrome, physical inactivity, smoking. The development of severe complications and a close connection with potentially fatal cardiovascular disorders make this disease a socially and economically significant problem. Treatment of chronic kidney disease in advanced stages belong to nephrologist duties. However, the success of preventive interventions depends on the time of their onset, which makes it relevant to identify the disease. The use of nephroprotective approaches by physicians of different specialties (general practitioners, cardiologists, gerontologists, nephrologists, endocrinologists) can significantly improve the prognosis of both those at risk of developing renal dysfunction and the existing disease. The review presents data on the clinical and laboratory efficacy of angiotensin-renin blocker use, as well as the combination of angiotensin II receptor blockers with calcium antagonists. Using the combination of the angiotensin II receptor blocker irbesartan and amlodipine as an example, we demonstrated the possibilities of nephroprotective therapy in patients with renal dysfunction.

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