Antihypertensive Treatment in Diabetic Kidney Disease: The Need for a Patient-Centered Approach.
RAAS inhibitors
SGLT-2 inhibitors
blood pressure target
cardiovascular outcome
diabetes
renal outcome
Journal
Medicina (Kaunas, Lithuania)
ISSN: 1648-9144
Titre abrégé: Medicina (Kaunas)
Pays: Switzerland
ID NLM: 9425208
Informations de publication
Date de publication:
16 Jul 2019
16 Jul 2019
Historique:
received:
04
06
2019
revised:
02
07
2019
accepted:
12
07
2019
entrez:
19
7
2019
pubmed:
19
7
2019
medline:
3
1
2020
Statut:
epublish
Résumé
Diabetic kidney disease affects up to forty percent of patients with diabetes during their lifespan. Prevention and treatment of diabetic kidney disease is currently based on optimal glucose and blood pressure control. Renin-angiotensin aldosterone inhibitors are considered the mainstay treatment for hypertension in diabetic patients, especially in the presence of albuminuria. Whether strict blood pressure reduction entails a favorable renal outcome also in non-albuminuric patients is at present unclear. Results of several clinical trials suggest that an overly aggressive blood pressure reduction, especially in the context of profound pharmacologic inhibition of the renin-angiotensin-aldosterone system may result in a paradoxical worsening of renal function. On the basis of this evidence, it is proposed that blood pressure reduction should be tailored in each individual patient according to renal phenotype.
Identifiants
pubmed: 31315312
pii: medicina55070382
doi: 10.3390/medicina55070382
pmc: PMC6681235
pii:
doi:
Substances chimiques
Antihypertensive Agents
0
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Déclaration de conflit d'intérêts
The authors declare no conflict of interest.
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