Renin inhibition and microalbuminuria development: meaningful predictor of kidney disease progression

Current Opinion in Nephrology and Hypertension
Lalitha De Silva, Matthew R Weir

Abstract

Microalbuminuria is an indicator of increased cardiovascular disease risk. Herein, we review microalbuminuria as a predictor of the onset and progression of renal disease in people with and without diabetes. We evaluate the data on the use of direct renin inhibitors (DRIs) for treatment of hypertension with microalbuminuria. It is known that DRIs have an antiproteinuric effect, whether used alone or with an angiotensin receptor blocker (ARB), independent of its hypotensive effects in patients with type 2 diabetes. A current study will determine if adding the DRI aliskiren to an angiotensin-converting enzyme inhibitor (ACEi) or an ARB will reduce cardiovascular and renal risk in patients with type 2 diabetes. DRIs are the latest addition to the class of renin-angiotensin-aldosterone system (RAAS) inhibitors available for patients with hypertension and kidney disease. Whether these drugs can improve upon the reduction of cardiovascular and renal risk with an ACEi or an ARB is unknown. Microalbuminuria is a surrogate marker for both cardiovascular and possibly renal endpoints. However, an ongoing issue is that the majority of patients with microalbuminuria will die of cardiovascular events before the onset of end-stage renal disea...Continue Reading

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Apr 17, 2013·Hypertension·Teba AlnimaUNKNOWN Rheos Pivotal Trial Investigators
Nov 8, 2016·Current Opinion in Nephrology and Hypertension·Jay L Koyner, Lakhmir S Chawla

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