Nephrology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Nephrology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Med Clin (Barc). 2021 Jun 11;156(11):561-567. doi: 10.1016/j.medcli.2020.12.025. Epub 2021 Mar 20.
Renin-angiotensin-aldosterone system blockers have shown to be effective in controlling blood pressure and proteinuria, slowing the progression to end stage renal disease and reducing cardiovascular risk, so they are the mainstream treatment of hypertension in chronic kidney disease. Their beneficial effects have been proven in multiple randomized clinical trials on different study populations, but there has recently been some controversial data on its use in some subgroups of patients, especially those with advanced chronic kidney disease. In some other populations such as patients with non-proteinuric nephropathies or the elderly, who can be more susceptible to its adverse events, their benefits have also been questioned. The aim of the present review is to collect available published data on the effect of renin-angiotensin-aldosterone system blockers in some controversial populations and provide perspective on future research areas in this field.
肾素-血管紧张素-醛固酮系统阻滞剂已被证明能有效控制血压和蛋白尿，延缓终末期肾病的进展，降低心血管风险，因此是慢性肾脏病高血压的主流治疗方法。它们的有益作用已在多个不同研究人群的随机临床试验中得到证实，但最近在某些亚组患者（尤其是晚期慢性肾脏病患者）的使用方面出现了一些有争议的数据。在其他一些人群中，如非蛋白尿性肾病患者或更容易发生不良反应的老年人，其益处也受到了质疑。本综述的目的是收集有关肾素-血管紧张素-醛固酮系统阻滞剂在一些有争议人群中的作用的现有发表数据，并就该领域的未来研究方向提供观点。
