Abstract
Proteinuric kidney disease, especially in the early and middle stages of renal insufficiency,
may be favorably affected by ACE-I/ARB. The progression of renal insufficiency is
thereby slowed down and dialysis obligation occurs later or can even be avoided. This
effect is independent of the underlying glomerular kidney disease. In the advanced
stage of renal insufficiency, the benefit of ACE-I/ARB cannot yet be conclusively
assessed. The interruption of ACE-I/ARB therapy may possibly contribute to a certain
recovery of renal function and delay the onset of dialysis a little. However, studies
are still pending and the benefits of ACE-I/ARB for the heart and blood vessels, especially
at this stage of renal insufficiency, should not be overlooked.
Patients with proteinuria benefit from ACE-I/ARB not only in terms of renal stabilization.
A cardio-protective effect by reduction of proteinuria and a delay of progression
is proven. On the other hand, the protective effect of ACE-I/ARB that can be detected
directly on the heart and blood vessels should not be disregarded. Thus, even if chronic
renal insufficiency no longer benefits directly from ACE-I/ARB therapy, cardiac protection
may still be of great importance to the chronic kidney patient.
Angiotensin-Converting-Enzyme-Inhibitoren (ACE-I) und Angiotensin-II-Rezeptor-Blocker
(ARB) werden häufig bei einer frühen Niereninsuffizienz eingesetzt. Sie verlangsamen
die Progression der Erkrankung und haben eine kardioprotektive Wirkung. Wie diese
Therapieform aber bei einer fortgeschrittenen Niereninsuffizienz (eGFR < 30 ml/min)
zu bewerten ist, darüber besteht eine nicht unerhebliche Unsicherheit.
Schlüsselwörter
ACE-Inhibitor - ARB - Filtrationsrate - kardioprotektiv - Diabetes
Key words
ACE inhibitor - ARB - filtration rate - cardioprotective - diabetes
