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Prevention of the Development and Progression of Renal Disease

National Kidney Disease Education Program, National Institute of Diabetes and Digestive and Kidney Diseases National Institutes of Health, Bethesda, Maryland.

Correspondence to Dr. Thomas H. Hostetter, Director, National Kidney Disease Education Program, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Division of Kidney, Urologic and Hematologic Diseases, 6707 Democracy Blvd., MSC 5458, Bethesda, MD 20892-5458. Phone: 301-594-8864; Fax: 301-480-3510;

ABSTRACT. Prevention of the major causes of ESRD, hypertension, and diabetes, is possible. Careful glycemic control can prevent diabetes nephropathy. BP control can likely prevent the large majority of hypertensive renal disease. Testing for diabetic renal disease is well founded. In contrast, screening for hypertensive kidney disease is less well defined. Most established renal disease can be treated with glycemic control in the case of diabetes, BP treatment with angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, and dietary protein restriction. Other therapeutic targets have been proposed, but are not well established. Future research should focus on defining the high risk patients, developing better markers of risk, and designing additional therapies. E-mail: HostetterT@extra.niddk.nih.gov

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Copyright © 2008 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673