The Japanese Journal of Clinical Dialysis Vol.24 No.9(3-1)

Theme New Insights into Uremic Conditions and Their Therapeutic Targets
Title Pharmacological intervention in patients with CKD
Publish Date 2008/08
Author Hiromichi Suzuki Department of Nephrology, Community Health Science Center, Saitama Medical University
[ Summary ] Two major therapeutic maneuvers for patients with chronic kidney disease (CKD) are diet modification and antihypertensive drugs including inhibitors of the renin-angiotensin-aldosterone system. Recently, in addition to these two treatments, other factors such as calcium-phosphorus metabolism, anemia, dyslipidemia, etc. have been focused on as risk factors for cardiovascular accidents in patients with CKD. Abnormalities in calcium and phosphorus levels are corrected by pharmacological interventions with sevelamer and cinacalcet. These two new agents correct calcium phosphorus abnormalities in patients with CKD. The levels of hemoglobin corrected by genetically produced erythropoietin have been a matter of debate. Recent meta-analysis has revealed that levels of hemoglobin would be safe at around 11 g / dl and cautioned that levels of hemoglobin exceeding 13 g / dl may increase death rates. The pathogenesis of dyslipidemia in patients with CKD remains unclear and decisive large scale studies are awaited.
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