Renin inhibition in the treatment of diabetic kidney disease

Radko Komers

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Inhibition of the RAAS (renin-angiotensin-aldosterone system) plays a pivotal role in the prevention and treatment of diabetic nephropathy and a spectrum of other proteinuric kidney diseases. Despite documented beneficial effects of RAAS inhibitors in diabetic patients with nephropathy, reversal of the progressive course of this disorder or at least long-term stabilization of renal function are often difficult to achieve, and many patients still progress to end-stage renal disease. Incomplete inhibition of the RAAS has been postulated as one of reasons for unsatisfactory therapeutic responses to RAAS inhibition in some patients. Inhibition of renin, a rate-limiting step in the RAAS activation cascade, could overcome at least some of the abovementioned problems associated with the treatment with traditional RAAS inhibitors. The present review focuses on experimental and clinical studies evaluating the two principal approaches to renin inhibition, namely direct renin inhibition with aliskiren and inhibition of the (pro)renin receptor. Moreover, the possibilities of renin inhibition and nephroprotection by interventions primarily aiming at non-RAAS targets, such as vitamin D, urocortins or inhibition of the succinate receptor GPR91 and cyclo-oxygenase-2, are also discussed.

Original languageEnglish (US)
Pages (from-to)553-566
Number of pages14
JournalClinical Science
Volume124
Issue number9
DOIs
StatePublished - May 2013

Fingerprint

Diabetic Nephropathies
Renin-Angiotensin System
Renin
Therapeutics
Urocortins
Angiotensins
Kidney Diseases
Succinic Acid
Prostaglandin-Endoperoxide Synthases
Aldosterone
Vitamin D
Chronic Kidney Failure
Kidney

Keywords

  • Aliskiren
  • Cyclo-oxygenase-2
  • Diabetic nephropathy
  • Prorenin
  • Renin-angiotensin system (RAS)
  • Urocortin
  • Vitamin D

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Renin inhibition in the treatment of diabetic kidney disease. / Komers, Radko.

In: Clinical Science, Vol. 124, No. 9, 05.2013, p. 553-566.

Research output: Contribution to journalArticle

Komers, Radko. / Renin inhibition in the treatment of diabetic kidney disease. In: Clinical Science. 2013 ; Vol. 124, No. 9. pp. 553-566.
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