Chronic kidney disease develops slowly, making the maintenance of renal function constantly between safety and danger. So, in the long-term treatment and monitoring the development of the disease, how to maintain the continuous stability of renal function is a major issue that needs attention.
Currently, there is still a lack of specific drugs to prevent further deterioration of renal function, which makes some kidney friends feel very worried.
But in fact, it is not that there is no “good medicine for protecting the kidney” in the treatment of kidney disease, but their effect is often weakened.
The two “protagonists” introduced today do not exist. The halo of too many protagonists is also everyone’s “old acquaintance”, but it is a timely rain for the treatment of various kidney diseases, bringing a glimmer of light to many kidney friends who are struggling with kidney disease!
Not much to say! The protagonist is on stage
It can not only reduce protein, but also protect the kidneys, lower blood pressure and blood sugar. It can be called a “model worker” drug!
These two types of drugs are angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs).
They are common antihypertensive drugs when they have not been confirmed by further studies to reduce urinary protein and delay renal function sclerosis. As can be seen from the name, it is mainly through the inhibition of angiotensin, which reduces the contraction of blood vessels and plays a role in lowering blood pressure.
The study further showed that ACEI and ARB, after the application of drugs in patients with nephropathy, can improve the systemic blood pressure while correcting the internal high pressure of the kidney, and improve the function of the glomerular basement membrane. It has a positive effect on the protection of glomerular permeability. The glomerular basement membrane is protected to slow down the development of fibrosis, thereby reducing the level of urinary protein, which can further delay the process of renal function sclerosis.
These two types of drugs have high blood pressure of patients with renal disease also have hypertensive nephropathy available, and most types of nephropathy are available.
For example, diabetic nephropathy, which benefits the most!
Diabetic nephropathy is a typical clinical symptom of microalbuminuria, which will progress to macroalbuminuria with continued development.
With two major metabolic problems such as hypertension and diabetes, the risk of developing uremia is very high.
Studies have shown that reducing urinary protein and controlling blood pressure and blood sugar stability are the keys to reducing the occurrence of uremia.
Drugs for controlling urinary protein in diabetic nephropathy are not conventional combinations of hormones and immunosuppressants.
As early as 2014, the Chinese Guidelines for Clinical Diagnosis and Treatment of Diabetic Nephropathy pointed out that ACEI/ARB is the first-line treatment drug for reducing microalbuminuria and macroalbuminuria in diabetic nephropathy.
in this year’s release of the Guidelines:
ACEI/ARB is still the drug of choice for reducing urinary protein in diabetic nephropathy. In addition, combined with feneridone can significantly reduce urinary protein.
In diabetic nephropathy, SGLT-2 inhibitors can be selected as hypoglycemic drugs and also have the effect of reducing urinary protein. SGLT-2 inhibitors, namely sodium-glucose co-transporter 2, include gliatzin drugs such as canagliflozin, dapagliflozin, empagliflozin, etc., which are relatively new type of hypoglycemic drugs, and clearly have Improve glomerulosclerosis and delay renal failure.
In addition, ACEI/ARB pril/sartan drugs are also widely used in nephrotic syndromes with a large amount of urinary protein, such as membranous nephropathy, Nephropathy such as focal stage sclerosing glomeruli.
Protect the kidney and heart, improve the quality of life
Patients with kidney disease who develop to the middle and late stages have abnormal blood pressure and lipid metabolism, which will increase the risk of cardiovascular disease and threaten their health. As antihypertensive drugs, ACEI/ARB pril/sartan also has a clear role in protecting the cardiovascular system, reducing the risks of coronary heart disease, arteriosclerosis, thrombosis, etc., and ensuring the quality of life.
Notes: Due to the fact that patients with renal disease have renal impairment, consider the safety of the kidneys and their bodies. These contraindications and side effects should be noted:p>
1. Lower blood pressure will cause increased renal blood perfusion. Pay attention to monitoring serum potassium and serum creatinine to avoid ischemia damage to renal function. Serum potassium > 6.0 mmol/L discontinuation, serum creatinine > 265 μmol/L pay attention to monitoring.
2. ACEI drugs may cause cough, hypotension, etc. If acceptable, do not stop the drug, if it is more serious, you can gradually reduce the drug and stop and change the drug medicine.
3. To prevent fetal malformation, it is prohibited to use in pregnant patients;
4. Congenital double renal arteries Stenosis, so as not to cause acute renal failure, disabled.
Many drugs used in the treatment of nephropathy are not actually one role, but also play multiple roles. Rational application is very beneficial to maintain the stability of renal function for a long time, and it is very beneficial to reduce the Uremia undoubtedly plays an important role.
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