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Titolo:
Aldosterone as a mediator of progressive renal disease: Pathogenetic and clinical implications
Autore:
Epstein, M;
Indirizzi:
Univ Miami, Sch Med, Dept Med, Miami, FL USA Univ Miami Miami FL USAUniv Miami, Sch Med, Dept Med, Miami, FL USA
Titolo Testata:
AMERICAN JOURNAL OF KIDNEY DISEASES
fascicolo: 4, volume: 37, anno: 2001,
pagine: 677 - 688
SICI:
0272-6386(200104)37:4<677:AAAMOP>2.0.ZU;2-5
Fonte:
ISI
Lingua:
ENG
Soggetto:
GENETICALLY HYPERTENSIVE RATS; CONVERTING ENZYME-INHIBITOR; SMOOTH-MUSCLE CELLS; HEART-FAILURE; BLOOD-PRESSURE; MINERALOCORTICOID RECEPTORS; SYSTEMIC HYPERTENSION; MYOCARDIAL FIBROSIS; VASCULAR INJURY; SPIRONOLACTONE;
Keywords:
aldosterone; aldosterone-receptor antagonist; hypertensive renal disease; end-stage renal disease (ESRD);
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
69
Recensione:
Indirizzi per estratti:
Indirizzo: Epstein, M Vet Affairs Med Ctr, Nephrol Sect, 1201 NW 16th St, Miami, FL 33125 USA Vet Affairs Med Ctr 1201 NW 16th St Miami FL USA 33125 3125 USA
Citazione:
M. Epstein, "Aldosterone as a mediator of progressive renal disease: Pathogenetic and clinical implications", AM J KIDNEY, 37(4), 2001, pp. 677-688

Abstract

End-stage renal disease is an enormous public health burden with an increasing incidence and prevalence. This escalating prevalence suggests that newer therapeutic interventions and strategies are needed to complement current anti hypertensive approaches. Although much evidence shows that angiotensin II mediates progressive renal disease, recent evidence also implicates aldosterone as an important pathogenetic factor in progressive renal disease. Several lines of experimental evidence show that selective blockade of aldosterone, independent of renin-angiotensin blockade, reduces proteinuria and nephrosclerosis in the spontaneously hypertensive stroke-prone rat modeland reduces proteinuria and glomerulosclerosis in the subtotally nephrectomized rat model (ie, remnant kidney). Although pharmacological blockade with angiotensin II-receptor blockers and angiotensin-converting enzyme inhibitors reduces proteinuria and nephrosclerosis and/or glomerulosclerosis, selective reinfusion of aldosterone restores these abnormalities despite continued renin-angiotensin blockade. Based on this theoretic construct, randomized clinical studies will be initiated to delineate the potential renal-protective effects of antihypertensive therapy using aldosterone-receptor blockade.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/03/20 alle ore 15:26:35