A renin-angiotenzin rendszer jelentósége a diabeteses nephropathia patogenezisében, klinikai képének kialakulásában és kezelésében.

Translated title of the contribution: Role of the renin-angiotensin system in the pathogenesis, clinical picture and treatment of diabetic nephropathy

I. Wittmann, Péter Degrell, Anette Komáromy, Gergó Attila Molnár, Zoltán Wagner, L. Wágner, István Mazák, J. Nagy

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Prevalence of diabetic nephropathy is increasing. Understanding of pathogenesis and clinical picture helps to manage this disease. Recent data of the research of this disease support that the renin-angiotensin system plays a pivotal role in the pathogenesis. Hyperglycaemia activates the renin-angiotensin system and induces transforming growth factor-beta expression. These both lead to glomerulosclerosis and tubulointerstitial fibrosis. Diabetic nephropathy develops earlier and progress faster in patients with DD or ID genotypes of angiotensin-I-converting-enzyme gene. Angiotensinogen and type 1 angiotensin-II-receptor gene mutations may be also predisposing factors for diabetic nephropathy. All these factors can be responsible for the hyperfiltration, albuminuria, salt sensitivity, and hypertension, which are characteristic features of diabetic nephropathy. According to these, one can suppose that inhibitors of the renin-angiotensin system are effective in the prevention and treatment of this disease. Evidence of clinical studies suggests that angiotensin-I-converting-enzyme inhibitors in type 1 diabetes can prevent overt nephropathy, decrease proteinuria, inhibit the loss of the glomerular filtration and decelerate progression. Angiotensin-II-receptor blockers exert the same effect in type 2 diabetic patients, and presumably angiotensin-I-converting-enzyme inhibitors have similar activity in this group of patients. That is why, in the case of intolerance of one class of drugs, the other should be substituted. Combination therapy of angiotensin-I-converting-enzyme inhibitors with angiotensin-II-receptor blockers can be the choice of treatment in the future.

Original languageHungarian
Pages (from-to)613-619
Number of pages7
JournalOrvosi Hetilap
Volume144
Issue number13
Publication statusPublished - Mar 30 2003

Fingerprint

Diabetic Nephropathies
Renin-Angiotensin System
Angiotensin-Converting Enzyme Inhibitors
Angiotensin Receptor Antagonists
Angiotensinogen
Angiotensin Type 1 Receptor
Albuminuria
Peptidyl-Dipeptidase A
Therapeutics
Type 1 Diabetes Mellitus
Proteinuria
Hyperglycemia
Causality
Transforming Growth Factor beta
Genes
Fibrosis
Salts
Genotype
Hypertension
Mutation

ASJC Scopus subject areas

  • Medicine(all)

Cite this

A renin-angiotenzin rendszer jelentósége a diabeteses nephropathia patogenezisében, klinikai képének kialakulásában és kezelésében. / Wittmann, I.; Degrell, Péter; Komáromy, Anette; Molnár, Gergó Attila; Wagner, Zoltán; Wágner, L.; Mazák, István; Nagy, J.

In: Orvosi Hetilap, Vol. 144, No. 13, 30.03.2003, p. 613-619.

Research output: Contribution to journalArticle

Wittmann, I. ; Degrell, Péter ; Komáromy, Anette ; Molnár, Gergó Attila ; Wagner, Zoltán ; Wágner, L. ; Mazák, István ; Nagy, J. / A renin-angiotenzin rendszer jelentósége a diabeteses nephropathia patogenezisében, klinikai képének kialakulásában és kezelésében. In: Orvosi Hetilap. 2003 ; Vol. 144, No. 13. pp. 613-619.
@article{cb4f4361b1bf45b89b06bd5492838def,
title = "A renin-angiotenzin rendszer jelent{\'o}s{\'e}ge a diabeteses nephropathia patogenezis{\'e}ben, klinikai k{\'e}p{\'e}nek kialakul{\'a}s{\'a}ban {\'e}s kezel{\'e}s{\'e}ben.",
abstract = "Prevalence of diabetic nephropathy is increasing. Understanding of pathogenesis and clinical picture helps to manage this disease. Recent data of the research of this disease support that the renin-angiotensin system plays a pivotal role in the pathogenesis. Hyperglycaemia activates the renin-angiotensin system and induces transforming growth factor-beta expression. These both lead to glomerulosclerosis and tubulointerstitial fibrosis. Diabetic nephropathy develops earlier and progress faster in patients with DD or ID genotypes of angiotensin-I-converting-enzyme gene. Angiotensinogen and type 1 angiotensin-II-receptor gene mutations may be also predisposing factors for diabetic nephropathy. All these factors can be responsible for the hyperfiltration, albuminuria, salt sensitivity, and hypertension, which are characteristic features of diabetic nephropathy. According to these, one can suppose that inhibitors of the renin-angiotensin system are effective in the prevention and treatment of this disease. Evidence of clinical studies suggests that angiotensin-I-converting-enzyme inhibitors in type 1 diabetes can prevent overt nephropathy, decrease proteinuria, inhibit the loss of the glomerular filtration and decelerate progression. Angiotensin-II-receptor blockers exert the same effect in type 2 diabetic patients, and presumably angiotensin-I-converting-enzyme inhibitors have similar activity in this group of patients. That is why, in the case of intolerance of one class of drugs, the other should be substituted. Combination therapy of angiotensin-I-converting-enzyme inhibitors with angiotensin-II-receptor blockers can be the choice of treatment in the future.",
author = "I. Wittmann and P{\'e}ter Degrell and Anette Kom{\'a}romy and Moln{\'a}r, {Gerg{\'o} Attila} and Zolt{\'a}n Wagner and L. W{\'a}gner and Istv{\'a}n Maz{\'a}k and J. Nagy",
year = "2003",
month = "3",
day = "30",
language = "Hungarian",
volume = "144",
pages = "613--619",
journal = "Orvosi Hetilap",
issn = "0030-6002",
publisher = "Akademiai Kiado",
number = "13",

}

TY - JOUR

T1 - A renin-angiotenzin rendszer jelentósége a diabeteses nephropathia patogenezisében, klinikai képének kialakulásában és kezelésében.

AU - Wittmann, I.

AU - Degrell, Péter

AU - Komáromy, Anette

AU - Molnár, Gergó Attila

AU - Wagner, Zoltán

AU - Wágner, L.

AU - Mazák, István

AU - Nagy, J.

PY - 2003/3/30

Y1 - 2003/3/30

N2 - Prevalence of diabetic nephropathy is increasing. Understanding of pathogenesis and clinical picture helps to manage this disease. Recent data of the research of this disease support that the renin-angiotensin system plays a pivotal role in the pathogenesis. Hyperglycaemia activates the renin-angiotensin system and induces transforming growth factor-beta expression. These both lead to glomerulosclerosis and tubulointerstitial fibrosis. Diabetic nephropathy develops earlier and progress faster in patients with DD or ID genotypes of angiotensin-I-converting-enzyme gene. Angiotensinogen and type 1 angiotensin-II-receptor gene mutations may be also predisposing factors for diabetic nephropathy. All these factors can be responsible for the hyperfiltration, albuminuria, salt sensitivity, and hypertension, which are characteristic features of diabetic nephropathy. According to these, one can suppose that inhibitors of the renin-angiotensin system are effective in the prevention and treatment of this disease. Evidence of clinical studies suggests that angiotensin-I-converting-enzyme inhibitors in type 1 diabetes can prevent overt nephropathy, decrease proteinuria, inhibit the loss of the glomerular filtration and decelerate progression. Angiotensin-II-receptor blockers exert the same effect in type 2 diabetic patients, and presumably angiotensin-I-converting-enzyme inhibitors have similar activity in this group of patients. That is why, in the case of intolerance of one class of drugs, the other should be substituted. Combination therapy of angiotensin-I-converting-enzyme inhibitors with angiotensin-II-receptor blockers can be the choice of treatment in the future.

AB - Prevalence of diabetic nephropathy is increasing. Understanding of pathogenesis and clinical picture helps to manage this disease. Recent data of the research of this disease support that the renin-angiotensin system plays a pivotal role in the pathogenesis. Hyperglycaemia activates the renin-angiotensin system and induces transforming growth factor-beta expression. These both lead to glomerulosclerosis and tubulointerstitial fibrosis. Diabetic nephropathy develops earlier and progress faster in patients with DD or ID genotypes of angiotensin-I-converting-enzyme gene. Angiotensinogen and type 1 angiotensin-II-receptor gene mutations may be also predisposing factors for diabetic nephropathy. All these factors can be responsible for the hyperfiltration, albuminuria, salt sensitivity, and hypertension, which are characteristic features of diabetic nephropathy. According to these, one can suppose that inhibitors of the renin-angiotensin system are effective in the prevention and treatment of this disease. Evidence of clinical studies suggests that angiotensin-I-converting-enzyme inhibitors in type 1 diabetes can prevent overt nephropathy, decrease proteinuria, inhibit the loss of the glomerular filtration and decelerate progression. Angiotensin-II-receptor blockers exert the same effect in type 2 diabetic patients, and presumably angiotensin-I-converting-enzyme inhibitors have similar activity in this group of patients. That is why, in the case of intolerance of one class of drugs, the other should be substituted. Combination therapy of angiotensin-I-converting-enzyme inhibitors with angiotensin-II-receptor blockers can be the choice of treatment in the future.

UR - http://www.scopus.com/inward/record.url?scp=0038727303&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0038727303&partnerID=8YFLogxK

M3 - Article

C2 - 12728786

AN - SCOPUS:0038727303

VL - 144

SP - 613

EP - 619

JO - Orvosi Hetilap

JF - Orvosi Hetilap

SN - 0030-6002

IS - 13

ER -