Next Step in Chronic Kidney Disease Therapy

D.D. Ivanov

Abstract


Angiotensin-converting enzyme inhibitors/angiotensin receptor blockers are the basis of renoprotection therapy in chronic kidney disease. Parallel to decrease of glomerular filtration rate, there is an increase in the activity of the sympathetic nervous system, and the number of functio­ning nephrons reduces, which requires a change of treatment regimen. Reducing the risk of cardiovascular events on the background of increased hypertension probably dictates the need for a priority administration of sympatholytics, calcium channel blockers and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers withdrawal. ARAMONEL formula: ARAMONEL — AR(B)A(CEI)MO(xonidine)NE(bivolol)L(ercandipine) is changed to MNELD — M(oxonidine)NE(bivolol)L(ercandipine)D(iuretic) that is used by us in recent years. Combined use of torsemide and xipamide is allowed. Angiotensin-converting enzyme inhibitors/angiotensin receptor blockers withdrawal requires evidence, which may be obtained in STOP-ACEi trial.


Keywords


angiotensin-converting enzyme inhibitor; angiotensin receptor blockers; calcium channel blockers; chronic kidney disease; estimated glome­rular filtration rate

References


Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease // Kidney inter. — 2013. — 3. — 1-150.

Grassi G. Sympathetic overdrive in hypertension: clinical and therapeutic relevance // The e-journal of the ESC Council for Cardiology Practice. — 24 Nov 2015. — Vol. 13, № 36.

Ivanov D. // Почки. Нирки. Kidneys. — 2016. — 1(16). — Р. 16.

Bhandari S. et al. // Nephrol. Dial. Transplant. — 2016. — 31(2). — 255-261.

http://www.health-medix.com/articles/misteztvo/2009-03-24/7-14.pdf

Ortiz M., Calcino G. Inferred mortality differences between dihydropypiridine antihypertensives // Hypertension. — 2009. — 53. — 1116.




DOI: https://doi.org/10.22141/2307-1257.0.2.16.2016.72205

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