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PredicateObject
rdf:type
lifeskim:mentions
pubmed:dateCreated
2005-6-6
pubmed:abstractText
ESRD represents a major health problem. The number of patients who enter kidney replacement programs has increased at an average of 7% per year in the past 10 yr. A large number of experimental and clinical studies have demonstrated that chronic nephropathies share common pathogenic mechanisms that contribute to renal disease progression, even independent of the original cause. Clinical studies found a significant correlation between the extent of urinary protein excretion and the rate of GFR decline in both diabetic and nondiabetic chronic nephropathies. Randomized trials, in particular the Ramipril Efficacy In Nephropathy (REIN) study, also showed that treatments that reduce proteinuria (namely angiotensin-converting enzyme [ACE] inhibitors) are renoprotective and limit progression to ESRD. Meta-analyses of randomized clinical trials also evaluated the role of proteinuria and of ACE inhibition therapy in chronic renal disease progression. Their findings were consistent with those of the REIN study and confirmed in larger series of patients the predictive value of proteinuria and the renoprotective effect of proteinuria reduction by ACE inhibition therapy. Thus, the meta-analyses may confirm and extend previous findings generated by randomized clinical trials. Conceivably, well-designed studies in properly selected and carefully monitored patients who are at increased risk continue to be the best approach to test novel hypotheses. The meta-analyses, however, represent a valuable tool to evaluate the consistency and generalizability of trial results to larger cohorts of patients.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Mar
pubmed:issn
1046-6673
pubmed:author
pubmed:issnType
Print
pubmed:volume
16 Suppl 1
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
S58-63
pubmed:dateRevised
2006-11-15
pubmed:meshHeading
pubmed-meshheading:15938036-Angiotensin-Converting Enzyme Inhibitors, pubmed-meshheading:15938036-Animals, pubmed-meshheading:15938036-Diet, Protein-Restricted, pubmed-meshheading:15938036-Disease Models, Animal, pubmed-meshheading:15938036-Disease Progression, pubmed-meshheading:15938036-Dose-Response Relationship, Drug, pubmed-meshheading:15938036-Drug Administration Schedule, pubmed-meshheading:15938036-Female, pubmed-meshheading:15938036-Glomerular Filtration Rate, pubmed-meshheading:15938036-Humans, pubmed-meshheading:15938036-Hypertension, pubmed-meshheading:15938036-Kidney Failure, Chronic, pubmed-meshheading:15938036-Kidney Function Tests, pubmed-meshheading:15938036-Male, pubmed-meshheading:15938036-Prognosis, pubmed-meshheading:15938036-Proteinuria, pubmed-meshheading:15938036-Ramipril, pubmed-meshheading:15938036-Risk Assessment, pubmed-meshheading:15938036-Severity of Illness Index, pubmed-meshheading:15938036-Treatment Outcome
pubmed:year
2005
pubmed:articleTitle
Angiotensin-converting enzyme inhibition and renal protection in nondiabetic patients: the data of the meta-analyses.
pubmed:affiliation
Mario Negri Institute for Pharmacological Research, Bergamo, Italy.
pubmed:publicationType
Journal Article, Comparative Study, Review, Meta-Analysis