Comparative effects of ACE inhibition and angiotensin II receptor blockade in the prevention of renal damage

Saulo Klahr, Jeremiah Morrissey

Research output: Contribution to journalArticlepeer-review

25 Scopus citations

Abstract

Angiotensin II (Ang II) regulates a number of genes associated with progression of renal disease. The regulation of gene expression by Ang II occurs through specific receptors that are linked to changes in the activity of transcription factors within the nucleus of target cells. In particular, members of the nuclear factor-κB family of transcription factors are activated, which in turn fuels at least two autocrine reinforcing loops that amplify Ang II and tumor necrosis factor-α formation. Angiotensin converting enzymes (ACE) inhibitors and angiotensin antagonists (AIIAs) differ both pharmacokinetically and pharmacodynamically in patients with end-stage renal disease (ESRD). Several ACE inhibitors (such as captopril, enalapril and lisinopril) are dialyzable, whereas all of the AIIAs studied are not. Dose titration may be necessary when administering ACE inhibitors to patients with renal failure (ESRD), but is rarely a consideration when AIIAs are used.

Original languageEnglish
Pages (from-to)S23-S26
JournalKidney International, Supplement
Volume62
Issue number82
DOIs
StatePublished - 2002

Keywords

  • Angiotensin converting enzyme inhibition
  • Chronic renal disease
  • Diabetic nephropathy
  • Progressive renal disease
  • Renoprotection

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