J Korean Med Assoc.  2003 Mar;46(3):246-254. 10.5124/jkma.2003.46.3.246.

Pharmacologic Therapy in Patients with Chronic Renal Failure

• Kang CM

• KMID: 1958060
• DOI: http://doi.org/10.5124/jkma.2003.46.3.246

Abstract

Chronic renal failure (CRF) is a functional diagnosis characterized by a progressive and generally irreversible decline in glomerular filtration rate (GFR). It is caused by a number of diseases, most commonly diabetes, glomerulonephritis, hypertension and the genetic diseases. The renal function of CRF patients declines by unrelenting progressive loss of nephron that persists long after the inciting event. CRF is not a curable disease. The aim of the treatment of CRF is to halt or delay the progression of renal failure and amelioration of symptoms, not to cure of the disease. Systemic hypertension, glomerular hypertension, proteinuria and protein-rich diet contribute to the progression of renal failure. Restriction of dietary protein intake help to preserve residual renal function. Among the antihypertensives, angiotensin converting enzyme inhibitor (ACEI) is the drug of choice for blood pressure control in CRF patients, because this class of drug reduces intraglomerular pressure. There is a growing awareness of a need not only to identify CRF patients at an earlier stage in the disease process, but also to initiate treatment strategies earlier to delay progression of CRF and to define the optimal time required to prepare CRF patients for renal replacement therapy. Early referral to the nephrologist is important for timely intervention. The consequences of late referral include increased morbidity and mortality. There is also an impact on patient's quality of life and missed opportunities for pre-emptive transplantation. Late referral also limits therapeutic options, and these limitations exert adverse effects on long-term outcomes once patients are on dialysis.

Keyword

CRF, CRF Progression; Diet therapy; Drug therapy

MeSH Terms

Antihypertensive Agents
Blood Pressure
Diagnosis
Dialysis
Diet
Diet Therapy
Dietary Proteins
Drug Therapy
Glomerular Filtration Rate
Glomerulonephritis
Humans
Hypertension
Kidney Failure, Chronic*
Mortality
Nephrons
Peptidyl-Dipeptidase A
Proteinuria
Quality of Life
Referral and Consultation
Renal Insufficiency
Renal Replacement Therapy
Antihypertensive Agents
Dietary Proteins
Peptidyl-Dipeptidase A

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