1. Direct inhibition of plasmatic renin activity with aliskiren: a promising but under-investigated therapeutic option for non-diabetic glomerulonephritis
- Author
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Annamaria Cerantonio, Giorgio Fuiano, Maria Lucia Citraro, Mariadelina Simeoni, Nicola Comi, Elena Pelagi, Ramona Nicotera, Maria Colao, Giuseppe Coppolino, Simeoni, M., Nicotera, R., Colao, M., Citraro, M. L., Pelagi, E., Cerantonio, A., Comi, N., Coppolino, G., and Fuiano, G.
- Subjects
Nephrology ,Amide ,medicine.medical_specialty ,Urology ,Intrarenal RAAS ,030232 urology & nephrology ,030204 cardiovascular system & hematology ,Pharmacology ,Plasma renin activity ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Glomerulonephritis ,Fumarates ,Diabetes mellitus ,Internal medicine ,Chronic kidney disease ,Renin–angiotensin system ,Renin ,Diabetes Mellitus ,Medicine ,Humans ,Glomerulonephriti ,Proteinuria ,business.industry ,Fumarate ,Non-diabetic ,Diabetes Mellitu ,Aliskiren ,medicine.disease ,Amides ,Endocrinology ,Treatment Outcome ,Tolerability ,chemistry ,Kidney Failure, Chronic ,medicine.symptom ,business ,Human - Abstract
Non-diabetic glomerulonephritis is a frequent cause of end-stage renal disease. The use of renin-angiotensin-aldosterone system blockers is a fundamental therapeutic approach. However, converting enzyme inhibitors (ACE-is) and angiotensin receptor blockers do not always achieve the desired target of proteinuria. The induction of the prorenin and renin up-regulation is a possible explanation. Aliskiren is the first drug acting as direct inhibitor of plasmatic renin activity, also able to interfere with the prorenin and renin profibrotic escape. We aimed at reviewing the literature for the assessment of potential efficacy and safety of aliskiren in the treatment of non-diabetic glomerulonephritis. The data on this topic are limited; however, we concluded for a possible usefulness of aliskiren. The renal safety profile appears potentially acceptable in non-diabetic patients although extreme carefulness, particularly with respect to long-term renal and cardiovascular tolerability, is recommended.
- Published
- 2015