Tylicki Leszek, Jakubowska Agnieszka, Lizakowski Sławomir, Świetlik Dariusz, Rutkowski Bolesław
Department of Nephrology Transplantology and Internal Medicine, Medical University of Gdansk, Poland
NZOZ Diaverum Dialysis Center Gdynia, Poland.
J Renin Angiotensin Aldosterone Syst. 2015 Mar;16(1):145-52. doi: 10.1177/1470320314550018. Epub 2014 Oct 16.
Reduction of blood pressure and proteinuria by blockade of the renin-angiotensin-aldosterone system (RAAS) has been the cornerstone of renoprotective intervention for patients with chronic kidney disease (CKD) for many years.
The aims were to check the use of angiotensin converting enzyme inhibitors (ACEIs) and/or angiotensin II receptor blockers (ARBs) in CKD patients.
This was a retrospective, cross-sectional study analysing data from medical records of patients who received specialist care in 1996, 2001, 2006, 2011 in the Outpatient Unit.
The numbers of CKD subjects included in the four independent surveys were as follows: 190, 490, 1799, 1696. The usage of RAAS blocking agents overall increased significantly in subsequent years as follows: 25, 49, 63, 74%. Patients with proteinuria and cardiovascular complications and/or diabetes were receiving RAAS blocking agents more commonly than others. The use of ACEI and/ or ARB in stage 4-5 CKD increased in subsequent years. In 2011 dual RAAS blockade was used in 10% CKD patients overall and 19% patients presented proteinuria.
The use of RAAS blocking agents were increasing in CKD patients under specialist care between 1996-2011. The quality of the management was gradually improved.
多年来，通过阻断肾素 - 血管紧张素 - 醛固酮系统（RAAS）来降低血压和蛋白尿一直是慢性肾脏病（CKD）患者肾脏保护干预的基石。
目的是检查慢性肾脏病患者中血管紧张素转换酶抑制剂（ACEI）和/或血管紧张素II受体阻滞剂（ARB）的使用情况。
这是一项回顾性横断面研究，分析了1996年、2001年、2006年、2011年在门诊接受专科护理的患者病历数据。
四项独立调查中纳入的慢性肾脏病患者数量如下：190例、490例、1799例、1696例。随后几年中，RAAS阻断剂的总体使用量显著增加，如下所示：25%、49%、63%、74%。有蛋白尿、心血管并发症和/或糖尿病的患者比其他患者更常使用RAAS阻断剂。在4 - 5期慢性肾脏病患者中，ACEI和/或ARB的使用在随后几年有所增加。2011年，总体上10%的慢性肾脏病患者使用了双重RAAS阻断，19%的患者有蛋白尿。
1996 - 2011年间，在专科护理下的慢性肾脏病患者中，RAAS阻断剂的使用在增加。管理质量在逐步提高。
