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Published in: Pediatric Nephrology 5/2008

Open Access 01-05-2008 | Educational Review

Therapeutic strategies to slow chronic kidney disease progression

Authors: Elke Wühl, Franz Schaefer

Published in: Pediatric Nephrology | Issue 5/2008

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Abstract

Childhood chronic kidney disease commonly progresses toward end-stage renal failure, largely independent of the underlying disorder, once a critical impairment of renal function has occurred. Hypertension and proteinuria are the most important independent risk factors for renal disease progression. Therefore, current therapeutic strategies to prevent progression aim at controlling blood pressure and reducing urinary protein excretion. Renin-angiotensin-system (RAS) antagonists preserve kidney function not only by lowering blood pressure but also by their antiproteinuric, antifibrotic, and anti-inflammatory properties. Intensified blood pressure control, probably aiming for a target blood pressure below the 75th percentile, may exert additional renoprotective effects. Other factors contributing in a multifactorial manner to renal disease progression include dyslipidemia, anemia, and disorders of mineral metabolism. Measures to preserve renal function should therefore also comprise the maintenance of hemoglobin, serum lipid, and calcium-phosphorus ion product levels in the normal range.
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Metadata
Title
Therapeutic strategies to slow chronic kidney disease progression
Authors
Elke Wühl
Franz Schaefer
Publication date
01-05-2008
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Nephrology / Issue 5/2008
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-008-0789-y

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