สำนักงานราชบัณฑิตยสภา

ประสิทธิ์ ฟูตระกูล และ นริสา ฟูตระกูล 49 วารสารราชบัณฑิตยสภา ปีที่ ๔๐ ฉบับที่ ๑ ม.ค.-มี.ค. ๒๕๕๘ Abstract An Urgent Call for Reconsideration of Chronic Kidney Disease Prasit Futrakul Fellow of the Academy of Science, The Royal Society, Thailand Bhumirajanagarindra, Kidney Institute Narisa Futrakul Department of Physiology, Chulalongkorn University Under present common practice, therapeutic strategy of chronic kidney disease fails to prevent the disease progression toward end-stage renal failure. Such practice failure is due to 1) insensitive diagnostic marker 2) inconclusive mechanism of renal disease progression 3) late therapeutic implementation and 4) altered vascular homeostasis. To solve the above clinical problems we implemented 1) sensitive diagnostic markers to recognize early stage of chronic kidney disease 2) renal microvascular disease and chronic renal ischemia to be the crucial mechanism of renal disease progression and be therapeutic forget 3) early therapeutic strategy with either vasodilators, exercise, or eating proper diet and 4) therapeutic responsiveness to treatment at early stage of chronic kidney disease due to an intact vascular homeostasis. All of these integrative strategies would improve the renal perfusion and function, as well as prevent the end-stage renal disease. In fact this innovative strategy is a sustainable development mimic the Theory of Self – Sufficiency of His Majesty King Bhumibol Adulyadej. Keywords : chronic kidney disease, diagnostic markers, renal perfusion, vascular homeostasis, renal microvascular disease