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中华肾病研究电子杂志 ›› 2022, Vol. 11 ›› Issue (06) : 301 -306. doi: 10.3877/cma.j.issn.2095-3216.2022.06.001

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肾素-血管紧张素-醛固酮系统抑制剂治疗伴有心力衰竭的慢性肾脏病
孙雪峰1,()   
  1. 1. 100853 北京,解放军总医院第一医学中心肾脏病医学部、解放军肾脏病研究所、肾脏疾病国家重点实验室、国家慢性肾病临床医学研究中心、肾脏疾病研究北京市重点实验室
  • 收稿日期:2022-06-21 出版日期:2022-12-28
  • 通信作者: 孙雪峰
  • 基金资助:
    国家自然科学基金面上项目(81870463,92049103)

RAAS inhibitors in the treatment of patients with chronic kidney disease accompanied by heart failure

Xuefeng Sun1,()   

  1. 1. Department of Nephrology, First Medical Center of Chinese PLA General Hospital, Chinese PLA Institute of Nephrology, State Key Laboratory of Kidney Diseases, National Clinical Research Center for Kidney Diseases, Beijing Key Laboratory of Kidney Diseases, Beijing 100853, China
  • Received:2022-06-21 Published:2022-12-28
  • Corresponding author: Xuefeng Sun
引用本文:

孙雪峰. 肾素-血管紧张素-醛固酮系统抑制剂治疗伴有心力衰竭的慢性肾脏病[J/OL]. 中华肾病研究电子杂志, 2022, 11(06): 301-306.

Xuefeng Sun. RAAS inhibitors in the treatment of patients with chronic kidney disease accompanied by heart failure[J/OL]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2022, 11(06): 301-306.

肾素-血管紧张素-醛固酮系统(RAAS)抑制剂是治疗慢性肾脏病和心力衰竭的基础用药,但应用于伴有心力衰竭的慢性肾脏病患者尚存问题。本文在介绍不同种类RAAS抑制剂的药理作用基础上,基于循证证据论述了RAAS抑制剂治疗慢性肾脏病和心力衰竭的疗效以及联合应用的问题,旨在为临床医生合理应用RAAS抑制剂治疗伴有心力衰竭的慢性肾脏病,提供借鉴和参考。

Renin angiotensin aldosterone system (RAAS) inhibitors are the basic drugs for the treatment of chronic kidney disease and heart failure, but there are still problems in the application of RAAS inhibitors for patients with chronic kidney disease accompanied by heart failure. Based on evidence-based medicine, this paper introduced the pharmacological effects of different kinds of RAAS inhibitors, and discussed the efficacy of RAAS inhibitors in the treatment of chronic kidney disease and heart failure, as well as problems in the combined application of RAAS inhibitors, so as to provide reference for clinicians to reasonably use RAAS inhibitors in the treatment of patients with chronic kidney disease accompanied by heart failure.

[1]
日本透析医学会. わが国の慢性透析疗法の现状[DB/OL]. 2020:

URL    
[2]
Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease [J]. Kidney Int Suppl, 2013, 3(1): 1-150.
[3]
McDonagh TA, Metra M, Adamo M, et al. 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure: developed by the task force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). With the special contribution of the Heart Failure Association (HFA) of the ESC [J]. Eur J Heart Fail, 2022, 24(1): 4-131.
[4]
Taddei S, Bortolotto L. Unraveling the pivotal role of bradykinin in ACE inhibitor activity [J]. Am J Cardiovasc Drugs, 2016, 16(5): 309-321.
[5]
Saavedra JM. Angiotensin receptor blockers are not just for hypertension anymore [J]. Physiology (Bethesda), 2021, 36(3): 160-173.
[6]
Balamuthusamy S, Srinivasan L, Verma M, et al. Renin angiotensin system blockade and cardiovascular outcomes in patients with chronic kidney disease and proteinuria: a meta-analysis [J]. Am Heart J, 2008, 155(5): 791-805.
[7]
Lesogor A, Cohn JN, Latini R, et al. Interaction between baseline and early worsening of renal function and efficacy of renin-angiotensin-aldosterone system blockade in patients with heart failure: insights from the Val-HeFT study [J]. Eur J Heart Fail, 2013, 15(11): 1236-1244.
[8]
Nistor I, De Sutter J, Drechsler C, et al. Effect of renin-angiotensin-aldosterone system blockade in adults with diabetes mellitus and advanced chronic kidney disease not on dialysis: a systematic review and meta-analysis [J]. Nephrol Dial Transplant, 2018, 33(1): 12-22.
[9]
Hou FF, Zhang X, Zhang GH, et al. Efficacy and safety of benazepril for advanced chronic renal insufficiency [J]. N Engl J Med, 2006, 354(2): 131-140.
[10]
Clark H, Krum H, Hopper I. Worsening renal function during renin-angiotensin-aldosterone system inhibitor initiation and long-term outcomes in patients with left ventricular systolic dysfunction [J]. Eur J Heart Fail, 2014, 16(1): 41-48.
[11]
Tai C, Gan T, Zou L, et al. Effect of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers on cardiovascular events in patients with heart failure: a meta-analysis of randomized controlled trials [J]. BMC Cardiovasc Disord, 2017, 17(1): 257.
[12]
Xu R, Sun S, Huo Y, et al. Effects of ACEIs versus ARBs on proteinuria or albuminuria in primary hypertension: a meta-analysis of randomized trials [J]. Medicine (Baltimore), 2015, 94(39): e1560.
[13]
Zhao M, Qu H, Wang R, et al. Efficacy and safety of dual vs single renin-angiotensin-aldosterone system blockade in chronic kidney disease: An updated meta-analysis of randomized controlled trials [J]. Medicine (Baltimore), 2021, 100(35): e26544.
[14]
Makani H, Bangalore S, Desouza KA, et al. Efficacy and safety of dual blockade of the renin-angiotensin system: meta-analysis of randomised trials [J]. BMJ, 2013, 346: f360.
[15]
Georgianos PI, Agarwal R. Mineralocorticoid receptor antagonism in chronic kidney disease [J]. Kidney Int Rep, 2021, 6(9): 2281-2291.
[16]
Berbenetz NM, Mrkobrada M. Mineralocorticoid receptor antagonists for heart failure: systematic review and meta-analysis [J]. BMC Cardiovasc Disord, 2016, 16(1): 246.
[17]
Pitt B, Filippatos G, Agarwal R, et al. Cardiovascular events with finerenone in kidney disease and type 2 diabetes [J]. N Engl J Med, 2021, 385(24): 2252-2263.
[18]
Quach K, Lvtvyn L, Baigent C, et al. The safety and efficacy of mineralocorticoid receptor antagonists in patients who require dialysis: a systematic review and meta-analysis [J]. Am J Kidney Dis, 2016, 68(4): 591-598.
[19]
Sato A, Saruta T. Aldosterone breakthrough during angiotensin-converting enzyme inhibitor therapy [J]. Am J Hypertens, 2003, 16(9 Pt 1): 781-788.
[20]
Hu LJ, Chen YQ, Deng SB, et al. Additional use of an aldosterone antagonist in patients with mild to moderate chronic heart failure: a systematic review and meta-analysis [J]. Br J Clin Pharmacol, 2013, 75(5): 1202-1212.
[21]
Pitt B, Filippatos G, Agarwal R, et al. Cardiovascular events with finerenone in kidney disease and type 2 diabetes [J]. N Engl J Med, 2021, 385(24): 2252-2263.
[22]
Alexandrou ME, Papagianni A, Tsapas A, et al. Effects of mineralocorticoid receptor antagonists in proteinuric kidney disease: a systematic review and meta-analysis of randomized controlled trials [J]. J Hypertens, 2019, 37(12): 2307-2324.
[23]
Gheorghiade M, Böhm M, Greene SJ, et al. Effect of aliskiren on postdischarge mortality and heart failure readmissions among patients hospitalized for heart failure: the ASTRONAUT randomized trial [J]. JAMA, 2013, 309(11): 1125-1135.
[24]
Zheng SL, Roddick AJ, Ayis S. Effects of aliskiren on mortality, cardiovascular outcomes and adverse events in patients with diabetes and cardiovascular disease or risk: a systematic review and meta-analysis of 13,395 patients [J]. Diab Vasc Dis Res, 2017, 14(5): 400-406.
[25]
McMurray JJ, Krum H, Abraham WT, et al. Aliskiren, enalapril, or aliskiren and enalapril in heart failure [J]. N Engl J Med, 2016, 374(16): 1521-1532.
[26]
Parving HH, Brenner BM, McMurray JJ, et al. Cardiorenal end points in a trial of aliskiren for type 2 diabetes [J]. N Engl J Med, 2012, 367(23): 2204-2213.
[27]
Volpe M, Rubattu S, Battistoni A. ARNi: a novel approach to counteract cardiovascular diseases [J]. Int J Mol Sci, 2019, 20(9): 2092.
[28]
Wang Y, Zhou R, Lu C, et al. Effects of the angiotensin-receptor neprilysin inhibitor on cardiac reverse remodeling: meta-analysis [J]. J Am Heart Assoc, 2019, 8(13): e012272.
[29]
Damman K, Gori M, Claggett B, et al. Renal effects and associated outcomes during angiotensin-neprilysin inhibition in heart failure [J]. JACC Heart Fail, 2018, 6(6): 489-498.
[30]
Feng Y, Yin Y, Deng R, et al. Renal safety and efficacy of angiotensin receptor-neprilysin inhibitor: A meta-analysis of randomized controlled trials [J]. J Clin Pharm Ther, 2020, 45(6): 1235-1243.
[31]
Gallo G, Tocci G, Fogacci F, et al. Blockade of the neurohormonal systems in heart failure with preserved ejection fraction: a contemporary meta-analysis [J]. Int J Cardiol, 2020, 316: 172-179.
[32]
Kuno T, Ueyama H, Fujisaki T, et al. Meta-analysis evaluating the effects of renin-angiotensin-aldosterone system blockade on outcomes of heart failure with preserved ejection fraction [J]. Am J Cardiol, 2020, 125(8): 1187-1193.
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