Renal pathophysiology and pharmacological mechanisms of nephroprotection

Several risk factors may affect the progression of chronic kidney disease (CKD). Arterial hypertension, proteinuria, obesity, intraglomerular hypertension, smoking and metabolic control in diabetes mellitus are the main modifiable risk factors for progression. The progression of CKD involves many ce...

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Published inSemergen, medicina de familia Vol. 49 Suppl 1; p. 102021
Main Authors Górriz, J L, Górriz-Zambrano, C, Pallarés-Carratalá, V
Format Journal Article
LanguageSpanish
Published Spain 01.06.2023
Subjects
Nephroangiosclerosis
Renin angiotensin system blockade
Bloqueo del sistema renina angiotensina
Renal progression
Interstitial fibrosis
Chronic kidney disease
Fibrosis intersticial
Progresión renal
Nefroangioesclerosis
Enfermedad renal crónica
Proteinuria
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Summary:Several risk factors may affect the progression of chronic kidney disease (CKD). Arterial hypertension, proteinuria, obesity, intraglomerular hypertension, smoking and metabolic control in diabetes mellitus are the main modifiable risk factors for progression. The progression of CKD involves many cellular processes that originate in specific compartments of the kidney, the vascular compartment with nephroangiosclerosis and the tubulointerstitial compartment with fibrosis and tubulointerstitial atrophy, and there may be overlap between both mechanisms. Given the involvement of so many risk factors and so many pathogenic pathways in the progression of CKD, the best hope for delaying or preventing the progression of CKD lies in a combined and multidisciplinary therapeutic approach, based on the existing evidence and acting on all these processes and pathways from the mechanistic point of view, and on a global process that is cardiovascular and renal risk to improve the prognosis of patients.
ISSN:1578-8865
DOI:10.1016/j.semerg.2023.102021