Stratégies pour ralentir la progression des maladies rénales chroniques
High blood pressure and proteinuria are the major factors that drive progression of chronic kidney disease. Target levels for preserving renal function are blood pressure less than 130/80 mmHg and proteinuria less than 0.5 g/day. Angiotensin II converting enzyme inhibitors and sartans should be used...
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| Vydáno v: | La Presse médicale (1983) Ročník 36; číslo 12; s. 1849 - 1855 |
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| Médium: | Journal Article |
| Jazyk: | francouzština |
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Elsevier Masson SAS
01.12.2007
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| ISSN: | 0755-4982, 2213-0276 |
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| Abstract | High blood pressure and proteinuria are the major factors that drive progression of chronic kidney disease.
Target levels for preserving renal function are blood pressure less than 130/80 mmHg and proteinuria less than 0.5 g/day.
Angiotensin II converting enzyme inhibitors and sartans should be used as first-line therapy to reach these targets.
Their use requires close monitoring of renal function and serum potassium levels.
Moderate sodium restriction, possibly combined with diuretic therapy, helps to maximize the effect of renin-angiotensin inhibitors.
Patients with chronic kidney disease have a high risk of acute kidney failure, especially due to drugs. All prescriptions must take into account the existence and extent of kidney disease.
Patient adhesion and collaboration between health professionals are required if these measures are to be effective in the long term.
Les 2 facteurs de progression majeurs des maladies rénale chronique sont l'hypertension artérielle systémique et la protéinurie.
Les cibles thérapeutiques permettant de préserver la fonction rénale sont une pression artérielle
<
130/80 mmHg et une protéinurie <
0,5 g/jour.
Les inhibiteurs de l'enzyme de conversion de l'angiotensine II et les sartans doivent être utilisés en priorité pour atteindre ces cibles thérapeutiques, éventuellement en association.
Leur utilisation nécessite la surveillance de la fonction rénale et de la kaliémie.
Une restriction sodée modérée éventuellement associée à un traitement diurétique permet une meilleure efficacité des inhibiteurs du système rénine-angiotensine.
Les patients insuffisants rénaux sont particulièrement exposés au risque d'insuffisance rénale aiguë, notamment du fait des médicaments, dont la prescription doit être prudente et adaptée à la fonction rénale.
Une bonne observance thérapeutique et une collaboration entre professionnels sont nécessaires pour que ces mesures soient efficaces à long terme. |
|---|---|
| AbstractList | High blood pressure and proteinuria are the major factors that drive progression of chronic kidney disease.
Target levels for preserving renal function are blood pressure less than 130/80 mmHg and proteinuria less than 0.5 g/day.
Angiotensin II converting enzyme inhibitors and sartans should be used as first-line therapy to reach these targets.
Their use requires close monitoring of renal function and serum potassium levels.
Moderate sodium restriction, possibly combined with diuretic therapy, helps to maximize the effect of renin-angiotensin inhibitors.
Patients with chronic kidney disease have a high risk of acute kidney failure, especially due to drugs. All prescriptions must take into account the existence and extent of kidney disease.
Patient adhesion and collaboration between health professionals are required if these measures are to be effective in the long term.
Les 2 facteurs de progression majeurs des maladies rénale chronique sont l'hypertension artérielle systémique et la protéinurie.
Les cibles thérapeutiques permettant de préserver la fonction rénale sont une pression artérielle
<
130/80 mmHg et une protéinurie <
0,5 g/jour.
Les inhibiteurs de l'enzyme de conversion de l'angiotensine II et les sartans doivent être utilisés en priorité pour atteindre ces cibles thérapeutiques, éventuellement en association.
Leur utilisation nécessite la surveillance de la fonction rénale et de la kaliémie.
Une restriction sodée modérée éventuellement associée à un traitement diurétique permet une meilleure efficacité des inhibiteurs du système rénine-angiotensine.
Les patients insuffisants rénaux sont particulièrement exposés au risque d'insuffisance rénale aiguë, notamment du fait des médicaments, dont la prescription doit être prudente et adaptée à la fonction rénale.
Une bonne observance thérapeutique et une collaboration entre professionnels sont nécessaires pour que ces mesures soient efficaces à long terme. |
| Author | Lasseur, Catherine Rigothier, Claire Combe, Christian Chauveau, Philippe Rigalleau, Vincent Vendrely, Benoît |
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| Cites_doi | 10.1136/bmj.317.7160.703 10.1111/j.1523-1755.1998.00840.x 10.1016/0140-6736(93)90190-R 10.1093/ndt/gfh408 10.1056/NEJMoa062276 10.1056/NEJMoa011303 10.1056/NEJM199311113292004 10.7326/0003-4819-139-4-200308190-00006 10.1001/jama.288.23.2981 10.1016/S0140-6736(98)04433-X 10.1016/S0140-6736(03)12229-5 10.1016/j.nephro.2005.02.010 10.1681/ASN.2004060505 10.1681/ASN.2006010012 10.1046/j.1523-1755.2001.00797.x 10.1056/NEJMoa011161 10.1056/NEJM199403313301301 10.1136/bmj.317.7160.713 10.1056/NEJM199604113341502 10.1046/j.1523-1755.1998.00067.x 10.1056/NEJMoa011489 10.1016/S0272-6386(96)90380-7 10.1056/NEJMoa053107 10.1016/S0140-6736(05)67814-2 10.1136/bmj.309.6958.833 10.1016/j.nephro.2006.10.002 10.1056/NEJMoa041031 10.1136/bmj.321.7274.1440 |
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