Date
2019Journal
American Journal of Kidney DiseasesPublisher
W.B. SaundersType
article
Metadata
Show full item recordAbstract
Hypertension and chronic kidney disease (CKD) are closely interlinked pathophysiologic states, such that sustained hypertension can lead to worsening kidney function and progressive decline in kidney function can conversely lead to worsening blood pressure (BP) control. The pathophysiology of hypertension in CKD is complex and is a sequela of multiple factors, including reduced nephron mass, increased sodium retention and extracellular volume expansion, sympathetic nervous system overactivity, activation of hormones including the renin-angiotensin-aldosterone system, and endothelial dysfunction. Currently, the treatment target for patients with CKD is a clinic systolic BP < 130 mm Hg. The main approaches to the management of hypertension in CKD include dietary salt restriction, initiation of treatment with angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, and diuretic therapy. Uncontrolled hypertension can lead to significant cardiovascular morbidity and mortality and accelerate progression to end-stage kidney disease. Although intensive BP control has not been shown in clinical trials to slow the progression of CKD, intensive BP control reduces the risk for adverse cardiovascular outcomes and mortality in the CKD population.Sponsors
Dr Ku is funded by NHLBI HL131023.Keyword
ambulatory blood pressure monitoring (ABPM)antihypertensive agents
blood pressure (BP)
BP control
cardiovascular outcomes
chronic kidney disease (CKD)
Hypertension
renin-angiotensin system (RAS)
review
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https://www.scopus.com/inward/record.uri?eid=2-s2.0-85063011514&doi=10.1053%2fj.ajkd.2018.12.044&partnerID=40&md5=a3c7b4f838bcd0030eaf4f4360df3e99; http://hdl.handle.net/10713/10241ae974a485f413a2113503eed53cd6c53
10.1053/j.ajkd.2018.12.044
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