TY - JOUR
T1 - Treatment of chronic kidney disease
AU - Turner, Jeffrey M.
AU - Bauer, Carolyn
AU - Abramowitz, Matthew K.
AU - Melamed, Michal L.
AU - Hostetter, Thomas H.
PY - 2012/2/2
Y1 - 2012/2/2
N2 - Treatment of chronic kidney disease (CKD) can slow its progression to end-stage renal disease (ESRD). However, the therapies remain limited. Blood pressure control using angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs) has the greatest weight of evidence. Glycemic control in diabetes seems likely to retard progression. Several metabolic disturbances of CKD may prove to be useful therapeutic targets but have been insufficiently tested. These include acidosis, hyperphosphatemia, and vitamin D deficiency. Drugs aimed at other potentially damaging systems and processes, including endothelin, fibrosis, oxidation, and advanced glycation end products, are at various stages of development. In addition to the paucity of proven effective therapies, the incomplete application of existing treatments, the education of patients about their disease, and the transition to ESRD care remain major practical barriers to better outcomes.
AB - Treatment of chronic kidney disease (CKD) can slow its progression to end-stage renal disease (ESRD). However, the therapies remain limited. Blood pressure control using angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs) has the greatest weight of evidence. Glycemic control in diabetes seems likely to retard progression. Several metabolic disturbances of CKD may prove to be useful therapeutic targets but have been insufficiently tested. These include acidosis, hyperphosphatemia, and vitamin D deficiency. Drugs aimed at other potentially damaging systems and processes, including endothelin, fibrosis, oxidation, and advanced glycation end products, are at various stages of development. In addition to the paucity of proven effective therapies, the incomplete application of existing treatments, the education of patients about their disease, and the transition to ESRD care remain major practical barriers to better outcomes.
KW - chronic kidney disease
KW - chronic renal disease
KW - chronic renal insufficiency
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U2 - 10.1038/ki.2011.380
DO - 10.1038/ki.2011.380
M3 - Review article
C2 - 22166846
AN - SCOPUS:84856436794
SN - 0085-2538
VL - 81
SP - 351
EP - 362
JO - Kidney international
JF - Kidney international
IS - 4
ER -
