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慢性肾脏病的治疗——合理降压控制尿蛋白逆转肾小球硬化

Treatment for chronic kidney disease:appropriate blood pressure control, controlling proteinuria, converting glomerulosclerosis

随着人口老龄化,糖尿病和动脉粥样硬化的发病率正逐年增加,随之而来慢性肾脏病(CKD)的发病率亦日益增高,由此导致终末期肾病(ESRD)的迅速增加,带来严重的社会和经济负担.CKD进展过程中伴随肾功能的逐渐丧失和高发心血管疾病的危险.治疗CKD的主要目的是对患者进行肾脏、心血管保护,延缓肾脏病变的发展,减少ESRD的发生,防止心血管事件的发生.应用降压药治疗CKD的主要靶目标就是控制高血压,减少尿蛋白或微量白蛋白排泄量,改善或防止脏器纤维化.

作 者:
侯凡凡 谢迪 HOU Fan-fan XIE Di  
作者单位:
南方医科大学南方医院肾内科,肾脏病研究所,广东,广州,510000 
刊 名:
中国实用内科杂志  ISTIC PKU
英文刊名:
CHINESE JOURNAL OF PRACTICAL INTERNAL MEDICINE 
年,卷(期):
2007 27(13) 
分类号:
R5 
关键词:
肾脏病,慢性 知识脉络  降压药 知识脉络 
机标分类号:
TP2 TM4 
机标关键词:
慢性肾脏病药治疗降压控制尿蛋白肾小球硬化chronic kidney disease发病率动脉粥样硬化终末期肾病脏器纤维化心血管事件心血管疾病心血管保护微量白蛋白人口老龄化控制高血压肾脏病变经济负担糖尿病肾功能 
基金项目:
 
DOI:
 
参考文献(12条)
  1. Chobanian AV.Bakris GL.Black HR The seventh report of the joint national committee on prevention,detection,evaluation,and treatment of high blood pressure:the JNC 7 report 2003(19)
  2. Peterson JC.Adler S.Burkart JM Blood pressure control,proteinuria,and the progression of renal disease.The modification of diet in renal disease study 1995(10)
  3. Jafar TH.Stark PC.Schmid CH Progression of chronic kidney disease:the role of blood pressure control,proteinuria,and angiotensin-converting enzyme inhibition:a patient-level meta-analysis 2003(4)
  4. Bakris GL.Weir MR.Secic M Differential effects of calcium antagonist subclasses on markers of nephropathy progression 2004(6)
  5. Locatelli F.Vecchio LD.D'Amico M Is it the agent or the blood pressure level that matters for renal protection in chronic nephropathies? 2002(z3)
  6. Ruggenenti P.Perna A.Remuzzi G Retarding progression of chronic renal disease:the neglected issue of residual proteinuria 2003(6)
  7. Forman JP.Brenner BM "Hypertension" and "microalbuminuria":the bell tolls for thee 2006(1)
  8. Brenner BM.Cooper ME.de Zeeuw D Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy 2001(12)
  9. Nakao N.Yoshimura A.Morita H Combination treatment of angiotensin-Ⅱ receptor blocker and angiotensin-converting-enzyme inhibitor in non-diabetic renal disease(COOPERATE):a randomised controlled trial 2003(9352)
  10. Remuzzi A.Gagliardini E.Sangalli F ACE inhibition reduces glomerulosclerosis and regenerates glomerular tissue in a model of progressive renal disease 2006(7)
  11. Fujihara CK.Velho M.Malheiros DM An extremely high dose of losartan affords superior renoprotection in the remnant model 2005(5)
  12. Fogo AB Progression versus regression of chronic kidney disease 2006(2)

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引证文献(3条) 
  1. 魏岩 高剂量缬沙坦治疗合并高血压的慢性肾小球肾炎疗效观察 [期刊论文] -齐齐哈尔医学院学报2009(9)
  2. 李建飞.温黎青.刘伏友.刘虹.彭佑铭.赵勤 不同剂量缬沙坦治疗合并高血压的慢性肾小球肾炎疗效研究 [期刊论文] -中国实用内科杂志2008(05)
  3. 李青.杨明.张扬.包玉倩.张磊.于浩泳.贾伟平.项坤三 2型糖尿病患者不同蛋白尿期肾小球滤过率的变化及影响因素 [期刊论文] -中华肾脏病杂志2008(01)

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