کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3846599 1248332 2011 12 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Off the Beaten Renin-Angiotensin-Aldosterone System Pathway: New Perspectives on Antiproteinuric Therapy
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی بیماری‌های کلیوی
پیش نمایش صفحه اول مقاله
Off the Beaten Renin-Angiotensin-Aldosterone System Pathway: New Perspectives on Antiproteinuric Therapy
چکیده انگلیسی
CKD is a major public health problem in the developed and the developing world. The degree of proteinuria associated with renal failure is a generally well accepted marker of disease severity. Agents with direct antiproteinuric effects are highly desirable therapeutic strategies for slowing, or even halting, progressive loss of kidney function. We review progress on therapies acting further downstream of the renin-angiotensin-aldosterone system pathway (e.g., transforming growth factor-beta antagonism, endothelin antagonism) and on those acting independent of the renin-angiotensin-aldosterone system pathway. In all, we discuss 26 therapeutic targets or compounds and 2 lifestyle changes (dietary modification and weight loss) that have been used clinically for diabetic or nondiabetic kidney disease. These therapies include endogenous molecules (estrogens, isotretinoin), biologic antagonists (monoclonal antibodies, soluble receptors), and small molecules. Where mechanistic data are available, these therapies have been shown to exert favorable effects on glomerular cell phenotype. In some cases, recent work has indicated surprising new molecular pathways for some therapies, such as direct effects on the podocyte by glucocorticoids, rituximab, and erythropoietin. It is hoped that recent advances in the basic science of kidney injury will prompt development of more effective pharmaceutical and biologic therapies for proteinuria.
ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Advances in Chronic Kidney Disease - Volume 18, Issue 4, July 2011, Pages 300-311
نویسندگان
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