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- W1569088697 abstract "The prevalence of chronic kidney disease (CKD) is on the rise, and it is estimated that more than 26 million Americans suffer from CKD1. The leading risk factors in the development of CKD are hypertension (HTN), diabetes mellitus (DM) and obesity. Because of the increasing prevalence of these risk factors as well as their frequent coexistence in the same patient, prevention strategies that would be able to decrease the progression of CKD to end stage renal disease (ESRD) are of paramount importance. There is a growing body of evidence showing that the activation of the renin angiotensin aldosterone system (RAAS) plays an important role in the development of cardiovascular and renal disorders2,3. RAAS is one of the key players in human physiology, and under normal physiological conditions it regulates blood pressure homeostasis, water balance, renal function and cellular growth. RAAS consists of a cascade of peptide hormones, with the enzyme renin catalyzing the first step in a cascade leading to the production of angiotensin I (AngI) from a precursor angiotensinogen (Figure 1). The cleavage of angiotensinogen, catalyzed by renin, is the rate-limiting step in RAAS activation. AngI does not possess vasoconstricting abilities, and it is cleaved by angiotensin-converting enzyme (ACE) into active angiotensin II (AngII). AngII binds to angiotensin receptors and exerts powerful vasoconstricting abilities. AngII also activates aldosterone production, and regulates sodium and water reapsorption (Figure 1). The kidneys are one of the major targets for RAAS as evidenced by the robust expression of RAAS components and receptors in the kidney4. Renal effects of AngII include regulation of renal blood flow, glomerular filtration rate (GFR) and sodium and water balance5. Upregulation of renal RAAS has been linked to the development of CKD in both HTN and DM4. Hence, therapies that modulate RAAS have emerged as essential tools in decreasing the progression of CKD. Pharmacological inhibition of RAAS can be obtained via three different mechanisms: 1. Inhibition of conversion of AngI to active AngII via angiotensin I converting enzyme inhibitors (ACEI); 2. Selective inhibition of angiotensin receptor 1 (AR-1) via angiotensin receptor blockers (ARB); 3. Direct inhibition of AngI production via direct rennin inhibitors (DRI)." @default.
- W1569088697 created "2016-06-24" @default.
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- W1569088697 date "2012-02-10" @default.
- W1569088697 modified "2023-10-03" @default.
- W1569088697 title "The Role of Renin Angiotensin System Inhibitors in Renal Protection: Lessons from Clinical Trials" @default.
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- W1569088697 doi "https://doi.org/10.5772/25957" @default.
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