Cantarovich F, Rangoonwala B
Transplantation Unit, Necker Hospital, Paris, France.
Int J Clin Pract. 2003 Nov;57(9):801-22.
Experimental and clinical research has supported the use of angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) in diabetic, hypertensive and proteinuric nephropathies. This review will evaluate the role of angiotensin II in the progression of renal damage in kidney diseases; the diagnostic value of microalbuminuria as an early clinical sign of renal damage and the possibility of preventing its further progression; the clinical results obtained with ACE inhibitors and/or ARBs in diabetic and non-diabetic nephropathies; and the therapeutic possibilities of ACE inhibitors and ARBs in renal transplantation. Based on available clinical data, ACE inhibitors can be considered to be the gold standard in reducing and/or preventing albuminuria, and thereby decreasing the percentage of patients who will progress to end-stage renal disease and death. Renal transplantation and chronic allograft nephropathy appear to be a promising field for the use of ACE inhibitors and ARBs.
实验和临床研究支持在糖尿病性、高血压性和蛋白尿性肾病中使用血管紧张素转换酶（ACE）抑制剂和血管紧张素II受体阻滞剂（ARB）。本综述将评估血管紧张素II在肾脏疾病肾损伤进展中的作用；微量白蛋白尿作为肾损伤早期临床征象的诊断价值以及预防其进一步进展的可能性；ACE抑制剂和/或ARB在糖尿病性和非糖尿病性肾病中获得的临床结果；以及ACE抑制剂和ARB在肾移植中的治疗可能性。基于现有临床数据，ACE抑制剂可被视为减少和/或预防蛋白尿、从而降低进展至终末期肾病和死亡患者比例的金标准。肾移植和慢性移植肾肾病似乎是使用ACE抑制剂和ARB的一个有前景的领域。
