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CZECH MEDICAL ASSOCIATION J. Ev. PURKYNĚ |
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Česky / Czech version | Vnitřní lékařství, 50, 2004, č. 7, s. 531 - 536 |
Renoprotective Effects of Antihypertensives Monhart V. III. interní oddělení Ústřední vojenské nemocnice, Praha, přednosta prim. MUDr. Věra Hamplová, CSc. |
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Summary: A characteristic feature of a majority of chronic renal diseases is their progressive course. The
speed of deterioration of renal function depends besides an aetiology of a primary disease on the
level of systemic (and glomerular) blood pressure and a degree of proteinuria. Angiotensin II
plays an important role in the use of hemodynamic and nonhemodynamic factors of progression.
Inhibitors of angiotensin converting enzyme or angiotensin antagonists comparable with other
hypertensives used in blood pressure control have more substantial renoprotective effects both in
diabetic and nondiabetic kidney diseases. A prerequisite of an effective renal protection is reaching
the target blood pressure corresponding with present European and American recommended
values < 130/80 mm Hg. The least risk of chronic renal disease progression is when systolic
blood pressure is 110 - 120 mm Hg and in proteinuria plain
1 g/24 hod. A practical implementation of renal protection is difficult in patients with renal
insufficiency in spite of the used combination of angiotensin converting enzyme inhibitors or
angiotensin antagonists and other antihypertensives.
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