Chronische Niereninsuffizienz

Zusammenfassung

Eine chronische Niereninsuffizienz ist auch schon bei milder Ausprägung mit einer deutlichen Steigerung von Morbidität und Mortalität assoziiert. Leider ist eine kausale Therapie einer chronischen Niereninsuffizienz nicht immer möglich. In diesen Fällen tritt die so genannten »supportive Therapie« in den Vordergrund. Eine besondere Bedeutung hat dabei die antihypertensive und antiproteinurische Therapie. Insbesondere Medikamente mit einer hemmenden Wirkung auf das Renin-Angiotensin-System haben nephroprotektive und antiproteinurische Wirkungen. Einen wichtigen Baustein der »supportiven Therapie« stellen auch diätetische Maßnahmen dar (Restriktion der Phosphat-, Kochsalz- und Proteinzufuhr u.a.).

Summary

Chronic renal failure: Therapeutic principles to retard progression with special regard to dietetic measures

Even mild chronic kidney failure is associated with a significant increase in morbidity and mortality. Unfortunately, a causal therapy is not always available and the so-called supportive therapy comes into the focus of interest. Antihypertensive and antiproteinuric treatment strategies are of outstanding importance. Medical treatment should especially aim at a blockade of the renin-angiotensin system to achieve renoprotective and antiproteinuric effects. Among others dietary salt, phosphate, and protein restriction are important elements of supportive renal therapy.

Schlüsselwörter

Arterielle Hypertonie - Diabetes mellitus - supportive Therapie - Nierenversagen - Progression

Key words

Arterial hypertension - Diabetes mellitus - renal failure - progression - nutrition - review

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