©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Nephrol. Feb 6, 2015; 4(1): 118-126
Published online Feb 6, 2015. doi: 10.5527/wjn.v4.i1.118
Published online Feb 6, 2015. doi: 10.5527/wjn.v4.i1.118
Time to re-evaluate effects of renin-angiotensin system inhibitors on renal and cardiovascular outcomes in diabetic nephropathy
Hiromichi Suzuki, Tomohiro Kikuta, Tsutomu Inoue, Ukihiro Hamada, Department of Nephrology and Community Health Science Center, Saitama Medical University, Saitama 350-0495, Japan
Author contributions: All authors contributed to this work.
Conflict-of-interest: The authors declare no conflict of interest in this study.
Correspondence to: Hiromichi Suzuki, MD, PhD, Department of Nephrology and Community Health Science Center, Saitama Medical University, 38 Moroyama-machi, Iruma-gun, Saitama 350-0495, Japan. iromichi@saitama-med.ac.jp
Telephone: +81-49-2761620 Fax: +81-49-2957338
Received: September 18, 2014
Peer-review started: September 18, 2014
First decision: November 1, 2014
Revised: November 13, 2014
Accepted: December 3, 2014
Article in press: December 10, 2014
Published online: February 6, 2015
Processing time: 142 Days and 2.7 Hours
Peer-review started: September 18, 2014
First decision: November 1, 2014
Revised: November 13, 2014
Accepted: December 3, 2014
Article in press: December 10, 2014
Published online: February 6, 2015
Processing time: 142 Days and 2.7 Hours
Core Tip
Core tip: The use of renin-angiotensin system (RAS) inhibitors, such angiotensin converting enzyme inhibitors/angiotensin-II receptor blockers, to slow progression of chronic kidney disease in a large group dominated by elderly people in the real world is not supported by available evidence. Since it is not clear that progression of kidney disease, and even of proteinuric diabetic nephropathy, is not inhibited through the use of RAS inhibitors, the most patient-centric goal of therapy for many elderly individuals should be individualized.