Nephroprotection: how to slow the progression of chronic renal insufficiency?

• Published in: Néphrologie & thérapeutique Vol. 1; no. 2; pp. 135 - 144
• Main Authors: Hannedouche, Thierry, Krummel, Thierry, Parvez-Braun, Laura
• Format: Journal Article
• Language: French
• Published: France 01.05.2005
• Subjects: Antihypertensive Agents - therapeutic use; Diabetic Nephropathies - therapy; Diet, Protein-Restricted; Diet, Sodium-Restricted; Disease Progression; Humans; Hypertension, Renal - prevention & control; Kidney Failure, Chronic - physiopathology; Kidney Failure, Chronic - psychology; Kidney Failure, Chronic - therapy; Life Style; Proteinuria - prevention & control; Randomized Controlled Trials as Topic; Renin-Angiotensin System - drug effects
• ISSN: 1769-7255

Most nephropathies are characterized by a progression that may result in end-stage renal failure (ESRF). Apart from the specific treatment implemented when possible, ESRF may be delayed by nephroprotective therapy. Following the definition of the risk factors likely to induce progressive renal disease, the various therapeutic strategies that may play a nephroprotective role are reviewed. The potential results are described with regard to published data, in particular randomised trials, as recommended by the evidence-based medicine principles. Blockade of the renin-angiotensin system plays a major role in terms of nephroprotection. However, this strategy should not replace lifestyle measures and pharmacological treatment of the metabolic disorders associated to nephropathies.