Vitamin D analogues to target residual proteinuria
| Autor: | Jelmer K. Humalda, Martin H. de Borst, Ravi Thadhani, David Goldsmith |
|---|---|
| Přispěvatelé: | Groningen Kidney Center (GKC), Lifestyle Medicine (LM), Vascular Ageing Programme (VAP), Groningen Institute for Organ Transplantation (GIOT) |
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
CHRONIC KIDNEY-DISEASE
D-BINDING PROTEIN medicine.medical_specialty Urology Renal function DIETARY-SODIUM RESTRICTION Angiotensin-Converting Enzyme Inhibitors vitamin D Cutting-Edge Renal Science Pharmacology urologic and male genital diseases DIABETIC-NEPHROPATHY Diabetic nephropathy cardiovascular disease medicine Vitamin D and neurology Humans Renal Insufficiency Chronic Risk factor CARDIOVASCULAR EVENTS URINARY SODIUM 1 25-DIHYDROXYVITAMIN D-3 Transplantation Proteinuria Cardio-Renal Syndrome business.industry Surrogate endpoint RANDOMIZED CONTROLLED-TRIAL medicine.disease Blockade RENIN-ANGIOTENSIN SYSTEM Nephrology 25-DIHYDROXYVITAMIN D-3 medicine.symptom proteinuria CHRONIC RENAL-DISEASE business chronic kidney disease Kidney disease |
| Zdroj: | Nephrology, Dialysis, Transplantation, 30(12), 1988-1994. Oxford University Press |
| ISSN: | 1460-2385 0931-0509 |
| Popis: | Residual proteinuria, the amount of proteinuria that remains during optimally dosed renin-angiotensin-aldosterone system (RAAS) blockade, is an independent risk factor for progressive renal function loss and cardiovascular complications in chronic kidney disease (CKD) patients. Dual RAAS blockade may reduce residual proteinuria but without translating into improved cardiorenal outcomes at least in diabetic nephropathy; rather, dual RAAS blockade may increase the risk of adverse events. These findings have challenged the concept of residual proteinuria as an absolute treatment target. Therefore, new strategies must be explored to address whether by further reduction of residual proteinuria using interventions not primarily targeting the RAAS benefit in terms of cardiorenal risk reduction would accrue. Both clinical and experimental intervention studies have demonstrated that vitamin D can reduce residual proteinuria through both RAAS-dependent and RAAS-independent pathways. Future research should prospectively explore vitamin D treatment as an adjunct to RAAS blockade in an interventional trial exploring clinically relevant cardiorenal end points. |
| Databáze: | OpenAIRE |
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