PDF(Pubmed)
Abstract：
Chronic kidney disease presents a health challenge that has a complex underlying pathophysiology, both acquired and inherited. The pharmacotherapeutic treatment options available today lower the progression of the disease and improve the quality of life but cannot completely cure it. This poses a challenge to the healthcare provider to choose, from the available options, the best way to manage the disease as per the presentation of the patient. As of now, the recommended first line of treatment to control the blood pressure in chronic kidney disease is the administration of renin-angiotensin-aldosterone system modulators. These are represented mainly by the direct renin inhibitor, angiotensin-converting enzyme inhibitors, and angiotensin II receptor blockers. These modulators are varied in their structure and mechanisms of action, hence showing varying treatment outcomes. The choice of administration of these modulators is determined by the presentation and the co-morbidities of the patient, the availability and affordability of the treatment option, and the expertise of the healthcare provider. A direct head-to-head comparison between these significant renin-angiotensin-aldosterone system modulators is lacking, which can benefit healthcare providers and researchers. In this review, a comparison has been drawn between the direct renin inhibitor (aliskiren), angiotensin-converting enzyme inhibitors, and angiotensin II receptor blockers. This can be of significance for healthcare providers and researchers to find the particular loci of interest, either in structure or mechanism, and to intervene as per the case presentation to obtain the best possible treatment option.
摘要：
慢性肾脏疾病提出了一个健康挑战，具有复杂的潜在病理生理学，既继承又继承。目前可用的药物治疗方案可降低疾病的进展并改善生活质量，但不能完全治愈。这对医疗保健提供者的选择提出了挑战，从可用的选项，根据患者的情况管理疾病的最佳方法。截至目前,在慢性肾脏病中,控制血压的推荐一线治疗是肾素-血管紧张素-醛固酮系统调节剂的给药.这些主要以直接肾素抑制剂为代表，血管紧张素转换酶抑制剂，血管紧张素II受体阻滞剂.这些调节剂的结构和作用机制各不相同，因此显示出不同的治疗结果。这些调节剂的给药选择取决于患者的表现和合并症。治疗方案的可用性和可负担性，以及医疗保健提供者的专业知识。缺乏这些重要的肾素-血管紧张素-醛固酮系统调节剂之间的直接头对头比较，这可以使医疗保健提供者和研究人员受益。在这次审查中,直接肾素抑制剂(阿利吉伦)，血管紧张素转换酶抑制剂，血管紧张素II受体阻滞剂.这对于医疗保健提供者和研究人员找到感兴趣的特定基因座具有重要意义。无论是在结构上还是机制上，并根据病例介绍进行干预，以获得最佳治疗方案。
