| 000 | nab a22 7a 4500 | ||
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| 999 |
_c15897 _d15897 |
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| 003 | PC15897 | ||
| 005 | 20200821133440.0 | ||
| 008 | 200423b xxu||||| |||| 00| 0 eng d | ||
| 040 | _cH12O | ||
| 041 | _aeng | ||
| 100 |
_9539 _aRuilope Urioste, Luis Miguel _eNefrología |
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| 245 | 0 | 0 |
_aAggressive blood pressure reduction and renin-angiotensin system blockade in chronic kidney disease: time for re-evaluation?. _h[artículo] |
| 260 |
_bKidney international, _c2014 |
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| 300 | _a85(3):536-46. | ||
| 500 | _aFormato Vancouver: Sarafidis PA, Ruilope LM. Aggressive blood pressure reduction and renin-angiotensin system blockade in chronic kidney disease: time for re-evaluation? Kidney Int. 2014 Mar;85(3):536-46. | ||
| 501 | _aPMID: 24048382 | ||
| 504 | _aContiene 86 referencias | ||
| 520 | _aOver the past decades, aggressive control of blood pressure (BP) and blockade of the renin-angiotensin-aldosterone system (RAAS) were considered the cornerstones of treatment against progression of chronic kidney disease (CKD), following important background and clinical evidence on the associations of hypertension and RAAS activation with renal injury. To this end, previous recommendations included a BP target of <130/80 mm Hg for all individuals with CKD (and possibly <125/75 mm Hg for those with proteinuria >1 g/day), as well as use of angiotensin-converting-enzyme inhibitors and angiotensin receptor blockers as first-line therapy for hypertension in all CKD patients. However, long-term extensions of relevant clinical trials support a low-BP goal only for patients with proteinuria, whereas recent cardiovascular trials questioned the benefits of low systolic BP for diabetic patients, leading to more individualized recommendations. Furthermore, our previous knowledge of the specific renoprotective properties of RAAS blockers in patients with proteinuric CKD is now extended with data on the use of these agents in patients with less advanced nephropathy and/or absence of proteinuria, deriving mostly from subanalyses of cardiovascular trials. This review discusses previous and recent clinical evidence on the issues of BP reduction and RAAS blockade by type and stage of renal damage, aiming to aid clinicians in their treatment decisions for patients with CKD. | ||
| 710 |
_986 _aServicio de Nefrología |
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_uhttp://pc-h12o-es.m-hdoct.a17.csinet.es/pdf/pc/1/pc15897.pdf _ySolicitar documento |
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_2ddc _cART _n0 |
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