Renin-angiotensin system blockade in diabetic kidney disease: an old pillar that still stands at the core of therapy.
Level 5 - mechanism / opinion, no new human data
Narrative review summarizing mechanistic concepts and existing clinical trials without primary data or systematic search methodology
PubMed 42521294 · doi:10.23876/j.krcp.26.225
What was done
This narrative review synthesized the pathophysiological mechanisms, clinical trial evidence, and safety considerations of renin-angiotensin system (RAS) inhibition via angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) in diabetic kidney disease (DKD).
What was found
The abstract reports qualitative summaries without quantitative data or effect estimates. It notes that RAS blockade reduces intraglomerular pressure, limits structural injury, reduces albuminuria, slows the decline of glomerular filtration rate, and delays kidney failure and heart failure events across stages of DKD. It also states that evidence shows routine discontinuation of RAS blockade in advanced chronic kidney disease does not improve renal function and may increase cardiorenal risk.
Why it matters
It reaffirms RAS blockade as the core standard-of-care foundation in diabetic kidney disease management, even as newer therapeutic classes emerge and questions regarding safety in advanced chronic kidney disease persist.
Limits
The paper is a non-systematic narrative review providing no original human data, statistical synthesis, or quantitative trial outcomes in the abstract. Specific criteria for study selection, quality assessment of cited trials, and formal risk of bias evaluations are not reported.
Cited by
- supports Diabetes and high blood sugar are the number one cause of kidney damage.