• Je něco špatně v tomto záznamu ?

The dilemma of dual renin-angiotensin system blockade in chronic kidney disease: why beneficial in animal experiments but not in the clinic

V. Čertíková Chábová, L. Červenka

. 2017 ; 66 (2) : 181-192.

Jazyk angličtina Země Česko

Typ dokumentu časopisecké články, přehledy

Perzistentní odkaz   https://www.medvik.cz/link/bmc18011449

Grantová podpora
NV15-28671A MZ0 CEP - Centrální evidence projektů

Drugs interfering with the renin-angiotensin-aldosterone system (RAAS) improved the prognosis in patients with hypertension, heart failure, diabetes and chronic kidney disease. However, combining different drugs brought no further benefit while increasing the risk of hyperkalemia, hypotension and acute renal failure. This was so with combining angiotensin converting enzyme inhibitors (ACEi) and angiotensin II receptors type 1 antagonists (ARB). Dissimilarly, in animal disease models this dual therapy proved clearly superior to single drug treatment and became the optimal standard regime for comparison with other treatments. This review analyzes the causes of the discrepancy of effects of the dual therapy between animal experiments versus clinical studies, and is focused on the outcomes in chronic kidney disease. Discussed is the role of species differences in RAAS, of the variability of the disease features in humans versus relative stability in animals, of the genetic uniformity in the animals but not in humans, and of the biased publication habits of experimental versus clinical studies. We attempt to understand the causes and reconcile the discordant findings and suggest to what extent dual RAAS inhibition should be continued in animal experiments and why its application in the clinics should be limited to strictly selected groups of patients.

Citace poskytuje Crossref.org

000      
00000naa a2200000 a 4500
001      
bmc18011449
003      
CZ-PrNML
005      
20180502083300.0
007      
ta
008      
180405s2017 xr d f 000 0|eng||
009      
AR
024    7_
$a 10.33549/physiolres.933607 $2 doi
035    __
$a (PubMed)28471687
040    __
$a ABA008 $b cze $d ABA008 $e AACR2
041    0_
$a eng
044    __
$a xr
100    1_
$a Čertíková-Chábová, Věra $u Department of Nephrology, First Faculty of Medicine, Charles University, Prague, Czech Republic $7 xx0095872
245    14
$a The dilemma of dual renin-angiotensin system blockade in chronic kidney disease: why beneficial in animal experiments but not in the clinic / $c V. Čertíková Chábová, L. Červenka
520    9_
$a Drugs interfering with the renin-angiotensin-aldosterone system (RAAS) improved the prognosis in patients with hypertension, heart failure, diabetes and chronic kidney disease. However, combining different drugs brought no further benefit while increasing the risk of hyperkalemia, hypotension and acute renal failure. This was so with combining angiotensin converting enzyme inhibitors (ACEi) and angiotensin II receptors type 1 antagonists (ARB). Dissimilarly, in animal disease models this dual therapy proved clearly superior to single drug treatment and became the optimal standard regime for comparison with other treatments. This review analyzes the causes of the discrepancy of effects of the dual therapy between animal experiments versus clinical studies, and is focused on the outcomes in chronic kidney disease. Discussed is the role of species differences in RAAS, of the variability of the disease features in humans versus relative stability in animals, of the genetic uniformity in the animals but not in humans, and of the biased publication habits of experimental versus clinical studies. We attempt to understand the causes and reconcile the discordant findings and suggest to what extent dual RAAS inhibition should be continued in animal experiments and why its application in the clinics should be limited to strictly selected groups of patients.
650    _2
$a akutní poškození ledvin $x chemicky indukované $x imunologie $x prevence a kontrola $7 D058186
650    _2
$a blokátory receptoru 1 pro angiotenzin II $x aplikace a dávkování $7 D047228
650    _2
$a inhibitory ACE $x aplikace a dávkování $x škodlivé účinky $7 D000806
650    _2
$a zvířata $7 D000818
650    12
$a modely nemocí na zvířatech $7 D004195
650    _2
$a medicína založená na důkazech $7 D019317
650    _2
$a lidé $7 D006801
650    _2
$a hyperkalemie $x chemicky indukované $x imunologie $x prevence a kontrola $7 D006947
650    _2
$a hypertenze $x chemicky indukované $x imunologie $x prevence a kontrola $7 D006973
650    _2
$a chronická renální insuficience $x farmakoterapie $x imunologie $7 D051436
650    _2
$a renin-angiotensin systém $x účinky léků $x imunologie $7 D012084
650    _2
$a druhová specificita $7 D013045
650    _2
$a výsledek terapie $7 D016896
655    _2
$a časopisecké články $7 D016428
655    _2
$a přehledy $7 D016454
700    1_
$a Červenka, Luděk, $d 1967- $7 xx0037105 $u Center for Experimental Medicine, Institute for Clinical and Experimental Medicine, Prague, Czech Republic; Department of Pathophysiology, Second Faculty of Medicine, Charles University, Prague, Czech Republic
773    0_
$w MED00003824 $t Physiological research $x 1802-9973 $g Roč. 66, č. 2 (2017), s. 181-192
856    41
$u https://pubmed.ncbi.nlm.nih.gov/28471687 $y Pubmed
910    __
$a ABA008 $b A 4120 $c 266 $y 4 $z 0
990    __
$a 20180405 $b ABA008
991    __
$a 20180425100702 $b ABA008
999    __
$a ok $b bmc $g 1296228 $s 1008261
BAS    __
$a 3
BAS    __
$a PreBMC
BMC    __
$a 2017 $b 66 $c 2 $d 181-192 $i 1802-9973 $m Physiological research $n Physiol. Res. (Print) $x MED00003824
GRA    __
$a NV15-28671A $p MZ0
LZP    __
$b NLK118 $a Pubmed-20180405

Najít záznam

Citační ukazatele

    Možnosti archivace