Conservative treatment of the uremic syndrome

• Published in: Seminars in dialysis 2009-07, Vol.22 (4), p.449-453
• Main Authors: Vanholder, Raymond, Argilés, Angel, Beige, Joachim, Brunet, Philippe, Drüeke, Tilman B, Fliser, Danilo, Herget-Rosenthal, Stefan, Hörl, Walter H, Jörres, Achim, Perna, Alessandra, Rodriguez-Portillo, Mariano, Spasovski, Goce, Stegmayr, Bernd, Stenvinkel, Peter, Wanner, Christoph, Wiecek, Andrzej, Massy, Ziad A
• Format: Article
• Language: English
• Subjects: Cardiovascular Diseases - prevention & control; Diet; Humans; Life Style; MEDICIN; Medicin och hälsovetenskap; MEDICINE; Renal Agents - therapeutic use; Uremia - therapy
• ISSN: 0894-0959; 1525-139X; 1525-139X
• DOI: 10.1111/j.1525-139X.2009.00600.x

In addition to extracorporeal renal replacement strategies, which in chronic kidney disease (CKD) are largely reserved for the treatment of end-stage kidney failure, conservative measures can be taken to reduce concentration, effects, or both concentration and effects of uremic retention solutes. In this overview, we will focus on those therapies, which are aimed at preventing or delaying cardio-vascular disease, retarding or halting the progression of CKD, or both. We will discuss, consecutively, inhibitors of the renin-angiotensin-aldosterone axis, beta-blockers, calcium-channel antagonists, anti-inflammatory drugs, intestinal sorbents, calcimimetics, and glitazones. Some of these approaches could lead to a therapeutic breakthrough in the future. In addition, comprehensive tables will be provided for more traditional therapeutic approaches, such as lifestyle changes and other pharmaceutical treatments.