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Therapeutic efficacy of renin—angiotensin blockade in patients receiving dialysisCorrespondence to: Hiromichi Suzuki, MD, PhD Department of Nephrology, Saitama Medical University, Saitama, Japan, iromichi{at}saitama-med.ac.jp Observational data in dialysis patients has indicated an increased cardiovascular mortality. One pathophysiological cause of this cardiovascular mortality in these patients is volume overload. In addition, an inappropriately activated renin—angiotensin system (RAS) has been proposed as another possible mechanism for the increased cardiovascular mortality. With these possible causes in mind, blockade of the RAS with an angiotensin-converting enzyme (ACE) inhibitor or an angiotensin receptor blocker (ARB) have both emerged as means of preventing cardiovascular events in this population. This review focuses on clinical evidence of the beneficial effects of ACE inhibitors and ARBs in dialysis patients with regard to the improvement of cardiovascular events as well as blood pressure control and maintenance of dialysis therapy.
Key Words: hemodialysis • peritoneal dialysis • renin—angiotensin system • angiotensin converting enzyme inhibitor • angiotensin type 1 receptor blocker
This version was published on October
1, 2009 Therapeutic Advances in Cardiovascular Disease, Vol. 3, No. 5,
397-405 (2009) |
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