Dr. Anbreen Shabbir, Dr. Maheen Zafar, Dr Adeela Sarfraz Khan
Introduction: Chronic kidney disease (CKD) is a major public health problem, and preventing CKD and/or delaying progression of CKD patients to end-stage renal disease (ESRD) is a major task for the nephrology community. Aim and objectives: The basic aim of the study is to analyze the role of protein restriction and Renin-Angiotensin-Aldosterone System in the management of chronic kidney diseases. Methodology of the study: This cross sectional study was conducted at Bahawal Victoria Hospital, Bahawalpur during 2019. This study was basically conducted for the analysis of role of RAAS in the management of CKD. For this purpose we make a thorough analysis and study of RAAS. Results: The RAAS is directly involved in the regulation of CKD, fluid volume, and vascular response to injury and inflammation. The inappropriate activation of this system causes hypertension, fluid retention, and inflammatory, thrombotic, and atherogenic effects that may contribute to end-organ damage in the long term. Although aldosterone (Aldo), renin, and several breakdown products of angiotensin I (AI) are also involved, most of the effects of the RAAS on target tissues are mediated by AII, which is generated both in the circulation and in the tissue. Conclusion: It is concluded that RAAS plays very important role in the management of CKD in local population of Pakistan. However there are some evidence that in patients with diabetic nephropathy that the antiproteinuric effect of mineralocorticoid receptor blockade (MRB) is at least in part mediated by a direct effect on the glomerular basement membrane and is not dependent solely on reduction in systemic BP, glomerular filtration or dietary factors.