Importance of Modulating the Renin-Angiotensin System in Preventing Renal Complications of Hypertension

Chronic kidney disease (CKD) is a major problem worldwide. It threatens the lives and health of many people and places severe financial burdens on health economies of even the wealthiest countries. It is clear that the approach to prevention is multifaceted including prevention of cardiovascular disease. Inhibitors of the RAS are the drugs of initial choice in preventing progressive CKD, and may be used cautiously in advanced renal insufficiency. In addition blood pressure must be optimally controlled to 130/80 mm Hg. Treatment of late CKD results only in a risk reduction and not a prevention of end stage renal disease. It is vital that patients at risk for CKD should be identified early before overt renal damage. Screening for microalbuminuria in patients with hypertension, metabolic syndrome and diabetes is particularly important.