Epstein M
Department of Medicine, University of Miami School of Medicine, Florida, USA.
Curr Opin Nephrol Hypertens. 1998 Mar;7(2):171-6. doi: 10.1097/00041552-199803000-00005.
End-stage renal disease, which signifies irreversible renal failure, constitutes a major and growing public health problem worldwide. The striking increase in end-stage renal disease has catalyzed clinical and investigative focus on pharmacologic interventions to retard progression to this condition. Increasing evidence indicates that some classes of antihypertensive medications may confer a greater effect than others in slowing progression of renal disease despite similar levels of blood pressure reduction. Substantive data indicate that angiotensin converting enzyme inhibition preferentially retards the progression of renal disease, primarily by protecting the injured kidney from hemodynamically mediated glomerular damage. Newer studies suggest that calcium antagonists also have diverse properties, which are independent of their renal microcirculatory effects that might afford renal protection.
终末期肾病意味着不可逆的肾衰竭，是全球范围内一个日益严重的重大公共卫生问题。终末期肾病的显著增加促使临床和研究重点关注延缓该病进展的药物干预措施。越来越多的证据表明，尽管各类降压药物降低血压的水平相似，但某些类别在减缓肾病进展方面可能比其他类别具有更大的效果。大量数据表明，血管紧张素转换酶抑制剂主要通过保护受损肾脏免受血流动力学介导的肾小球损伤，优先延缓肾病进展。最新研究表明，钙拮抗剂也具有多种特性，这些特性独立于其可能提供肾脏保护作用的肾微循环效应。
