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JAOA • Vol 105 • No 4 • April 2005 • 207-215
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REVIEW ARTICLE

Slowing Progression Along the Renal Disease Continuum

Nelson P. Kopyt, DO

From Temple University, Philadelphia, Pa, and the Department of Nephrology, Lehigh Valley Hospital, Allentown, Pa.

Address correspondence to Nelson Kopyt, DO, FACP, Nephrology Hypertension Associates of the Lehigh Valley, 50 S 18th St, Easton, PA 18042-3912.E-mail: DrNPK{at}aol.com

Patients in whom nephropathy develops as a result of hypertension or diabetes mellitus are more likely to die of cardiovascular disease (CVD) than of kidney disease. An early sign of impending nephropathy is microalbuminuria, defined as urinary excretion of albumin at a rate of 28.8 mg/24 h to 288 mg/24 h. Microalbuminuria is a marker of endothelial dysfunction, vascular injury, and renal disease and CVD, and it is associated with increased risk for myocardial infarction. Oxidative stress and endothelial dysfunction are unifying factors mediated by the renin-angiotensin system in renal disease and CVD. Clinical trials show reduced cardiovascular risk and a reversal of microalbuminuria with the use of agents that affect the renin-angiotensin system: angiotensin-receptor blockers in patients with type 2 diabetes mellitus and nephropathy, or angiotensin-converting enzyme inhibitors in patients with type 1 diabetes mellitus.


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Correction

JAOA 2005 105: 427. [Full Text]  



This article has been cited by other articles:


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