Danneel Charline, Sauvage Camille, Hayef Mohamed Nabil, Desmet Véronique, Surquin Murielle, Nortier Joëlle, De Vriese Carine
Department of Pharmacy, Centre Hospitalier Universitaire Brugmann, Place Arthur Van Gehuchten 4, 1020 Brussels, Belgium.
Department of Dietetics, Centre Hospitalier Universitaire Brugmann, Place Arthur Van Gehuchten 4, 1020 Brussels, Belgium.
Biomedicines. 2025 Apr 19;13(4):994. doi: 10.3390/biomedicines13040994.
Moderate-to-severe chronic kidney disease (CKD) is a public health problem affecting hundreds of millions of people around the world. Started early, nephroprotection measures are able to prevent the degradation of renal function and are a major issue in CKD management. This approach consists of a combination of pharmacological and non-pharmacological treatments aimed at slowing down the decline in renal filtration capacity and improving patient well-being. Drugs such as angiotensin-converting enzyme inhibitors, angiotensin II receptor antagonists, and sodium-glucose cotransport type 2 inhibitors play a crucial role in reducing intraglomerular pressure and renal inflammation. Their beneficial effects are potentiated when they are combined with non-pharmacological approaches, such as salt and protein restriction. This present review provides a critical overview of the current pharmacological and nutritional therapies that may slow down the progression of CKD. Recently, many pharmacological treatments have opened up new perspectives for managing this condition. Nevertheless, prevention remains the cornerstone of effective disease management. Actually, very few studies include both pharmacists and dietitians in their interdisciplinary team mainly represented by nephrologists, nurses, and social workers. However, their specific collaboration may significantly improve the knowledge and skills to help patients in their own CKD management. Future research is required to assess the benefit of collaboration in supporting patients with moderate-to-severe CKD before any concern of renal replacement therapy (RRT).
中重度慢性肾脏病（CKD）是一个影响全球数亿人的公共卫生问题。早期启动的肾脏保护措施能够预防肾功能退化，是CKD管理中的一个主要问题。这种方法包括药物治疗和非药物治疗的联合应用，旨在减缓肾滤过能力的下降并改善患者的健康状况。诸如血管紧张素转换酶抑制剂、血管紧张素II受体拮抗剂和钠-葡萄糖协同转运蛋白2抑制剂等药物在降低肾小球内压力和减轻肾脏炎症方面发挥着关键作用。当它们与非药物方法（如限制盐和蛋白质摄入）联合使用时，其有益效果会得到增强。本综述对当前可能减缓CKD进展的药物治疗和营养治疗进行了批判性概述。最近，许多药物治疗为管理这种疾病开辟了新的前景。然而，预防仍然是有效疾病管理的基石。实际上，在主要由肾病学家、护士和社会工作者组成的跨学科团队中，很少有研究纳入药剂师和营养师。然而，他们的具体合作可能会显著提高帮助患者进行自身CKD管理的知识和技能。在考虑任何肾脏替代治疗（RRT）之前，需要开展未来研究来评估合作对支持中重度CKD患者的益处。
