CARDIOVASCULAR PATIENT WITH STAGE 1-3 CHRONIC KIDNEY DISEASE: CONTEMPORARY CARDIONEPHROPROTECTION IN REAL CLINICAL PRACTICE

Abstract

The article provides a review of data on cardiovascular patients’ treatment, with 1-3 grades of chronic kidney disease (CKD). It is shown that for cardiovascular patients the function of kidneys must be assessed before beginning of treatment, which is important for on-time diagnostics of CKD. Practitioners must remember that patients with the 3rd grade of CKD require specific nephroprotection. On all stages of the disease optimal nephroprotectors are inhibitors of renin-angiotensine system (RAs) (blockers of angiotensine receptors (ARB) and angiotensine converting enzyme inhibitors (ACei)). The evidence provided for relation of ARBs nephroprotective effect with dosage, and that these drugs must be used in highest tolerated dosages, but not in minimal effective dosage that leads to normalization of BP. It is shown that combination of ACei and ARBs with statins enhances cardiorenal protection as a result of nephroprotective effects synergy of statins and RAs inhibitors.

Keywords

• chronic kidney disease
• nephroprotection
• angiotensine receptor blockers
• valsartan
• rosuvastatin