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25 Cards in this Set
- Front
- Back
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captopril
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ACE inhibitor
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enalopril
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ACE inhibitor
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Reduce glomerular capillary pressure by inhibition of angiotensin II concentrations
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ACE inhibitor
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associated with slower decline in CrCl, decrease proteinuria (35-60% vs. placebo) and subsequently progression of kidney disease
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ACE inhibitor
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Strongest clinical outcomes are in patients with Type 1 diabetes with albuminuria or proteinuria.
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ACE inhibitor
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losartan
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Angiotensin II Receptor Blockers
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ibersartan
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Angiotensin II Receptor Blockers
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Selective inhibition of angiotensin II at the AT1 receptor
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Angiotensin II Receptor Blockers
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reduction of proteinuria (30-60% vs. placebo) independent of systemic blood pressure reduction
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Angiotensin II Receptor Blockers
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Agents that block the AT1 receptors has been promoted to provide more complete attenuation of the angiotensin II action, particularly because non ACE pathways, such as, chymases and endopeptidases can generate angiotensin II
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Angiotensin II Receptor Blockers
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decrease tissue angiotensin II to a greater extent than either agent alone
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ACEi and ARB combination therapy
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Human studies to date confirm decrease urinary albuminuria/ proteinuria by 25-45% in patients with Type 1 and Type 2 DM compared to monotherapy with ACEi or ARB.
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ACEi and ARB combination therapy
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non-dihydropyridines (NDHCCB
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Calcium channel blockers
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diltiazem
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Calcium channel blockers
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verapamil
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Calcium channel blockers
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significant dilation at the afferent arteriole resulting in loss of renal autoregulation
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calcium channel blocker
dihydropyridines (DHCCB) (amlodipine and felodipine) |
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increase intraglomerular capillary pressure and may increase proteinuria
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DHCCB class
(amlodipine and felodipine) |
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reduce glomerular pressure and reduce proteinuria
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calcium channel blocker
NDHCCB |
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Microalbuminuria is the strongest independent predictor for developing ESRD
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just a fact
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Lower urinary protein excretion rates dramatically
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ACE and ARBs
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Reduce relative risk for doubling of Scr or developing ESRD
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ACE and ARBs
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Benefit associated with these agents is independent of their anti-hypertensive effect: increase dose to maximum effect
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ACE and ARBs
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• Uncontrolled chronic hyperglycemia leads to accumulation of glycosylated endproducts in the glomerulus increase glomerular filtration and increase proteinuria
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Diabetes Mellitus
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Strict blood glucose control decrease risk of microalbuminuria and proteinuria by 34-56%, respectively in the above trials
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Diabetes Mellitus
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Adverse lipoprotein profile has been associated with a higher prevalence and advance rate of CKD
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Dyslipidemia
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