Kidney international
-
Kidney international · Mar 2007
CommentMeasuring risk in end-stage renal disease: is N-terminal pro brain natriuretic peptide a useful marker?
Natriuretic peptides are important in the maintenance of body volume homeostasis. There has been interest in utilizing the levels of these peptides to diagnose and prognosticate cardiovascular disease. In end-stage renal disease, the diagnostic utility of these peptides is limited. Madsen et al. report that levels of N-terminal pro brain natriuretic peptide (NT-proBNP) levels offer important information on the risk of mortality in patients undergoing hemodialysis.
-
Kidney international · Mar 2007
CommentRenal albumin handling: a look at the dark side of the filter.
Renal albumin handling is of major interest because albuminuria is an important risk factor for reno-cardiovascular diseases. In this issue a challenging study attempts to shift the paradigm of very low fractional albumin filtration and degradation in proximal tubule cells. The conclusions are of great potential relevance but require urgent validation so that we gain a clearer view of the dark side of the glomerular filter.
-
Kidney international · Dec 2006
Comment ReviewComprehensive suppression of the renin-angiotensin-aldosterone system in chronic kidney disease: covering all of the bases.
Reducing proteinuria and blood pressure in chronic kidney disease (CKD) decreases rate of progression. Inhibition of the renin-angiotensin system by angiotensin-converting enzyme inhibitors and/or angiotensin receptor blockers is beneficial in reducing proteinuria but incomplete in suppressing aldosterone production and its renal effects. Adding aldosterone receptor blockers to these other agents may further halt the progression of CKD.
-
Renal artery stenosis is common especially in patients with generalized atherosclerosis. It is frequently associated with difficult-to-treat hypertension and with renal failure. ⋯ Advances in imaging and interventional devices offer new opportunities, however, clinicians still have to decide individually in every patient to treat or not to treat stenosis with revascularization. This review evaluates the current literature in order to help the physician to find the right decision in this challenging clinical issue.