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Phosphodiesterase type 5 inhibitors and kidney disease

  • Nephrology - Review
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Abstract

Chronic kidney disease (CKD) represents a worldwide health problem. Traditionally, the nephroprotective treatment for CKD aims to slow progression to end-stage renal disease and includes dietary protein restriction, correction of metabolic acidosis, and renin–angiotensin system blockers. However, current standard therapeutic options may not be enough for preventing CKD progression in a subset of patients making necessary to develop novel therapeutic options to further slow renal function loss. Phosphodiesterase type 5 (PDE5) inhibitors represent a class of drugs traditionally used to treat erectile dysfunction and pulmonary hypertension. However, recent evidence suggests that PDE5 inhibitors may have additional therapeutic effects, such as cardioprotection and cerebrovascular protection. In the current review, we summarize PDE5 inhibitors’ utility in disease states and clinical conditions related to kidney disease such as systemic hypertension and acute and chronic kidney injury and discuss the mechanisms explaining possible kidney protective roles of PDE5 inhibitors. A recently completed phase 2 trials demonstrated that the long-acting PDE5 inhibitor PF-00489791 decreased albuminuria in patients with overt diabetic nephropathy when added on top of renin–angiotensin system blockade.

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Acknowledgments

AO was supported by PI13/00047, PIE13/00051, ISCIII-RETIC REDinREN RD12/0021 Fondos FEDER, S2010/BMD-2378, FRIAT-IRSIN, and Programa Intensificación Actividad Investigadora (ISCIII/Agencia Laín-Entralgo/CM).

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Authors and Affiliations

  1. Division of Nephrology, Department of Medicine, Konya Numune State Hospital, Konya, Turkey

    Baris Afsar

  2. Nephrology and Hypertension Department, IIS-Fundacion Jimenez Diaz and School of Medicine, Madrid, Spain

    Alberto Ortiz

  3. Nephrology Clinic, Dialysis and Renal Transplant Center, ‘C.I. PARHON’ University Hospital, Bucharest, Romania

    Adrian Covic

  4. ‘Grigore T. Popa’ University of Medicine, Iasi, Romania

    Adrian Covic

  5. Extracorporeal Hemocorrection Unit, JSC “National Scientific Medical Research Center”, Astana, Kazakhstan

    Abduzhappar Gaipov

  6. Department of Urology, Koc University School of Medicine, Istanbul, Turkey

    Tarik Esen

  7. Renal and Transplantation Department, Guy’s and St Thomas’ Hospitals, London, UK

    David Goldsmith

  8. Department of Medicine, Division of Nephrology, Koc University School of Medicine, Sariyer, Istanbul, Turkey

    Mehmet Kanbay

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  1. Baris Afsar
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  2. Alberto Ortiz
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  3. Adrian Covic
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  4. Abduzhappar Gaipov
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Correspondence to Mehmet Kanbay.

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This is a review and no need for ethical approval. This article does not contain any studies with human participants or animals performed by any of the authors.

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Afsar, B., Ortiz, A., Covic, A. et al. Phosphodiesterase type 5 inhibitors and kidney disease. Int Urol Nephrol 47, 1521–1528 (2015). https://doi.org/10.1007/s11255-015-1071-4

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