Managing Kidney Disease with Blood-pressure Control

Overview

Journal Nat Rev Nephrol

Specialty Nephrology

Date 2011 Jun 22

PMID 21691318

Citations 13

Authors

Elke Wuhl

Franz Schaefer

Affiliations

Soon will be listed here.

Abstract

The progression of chronic kidney disease (CKD) is largely independent of the underlying kidney disorder once renal function has fallen below a critical level. Hypertension is an independent risk factor for disease progression in both adult and pediatric patients with kidney disorders. Increasing evidence from clinical trials indicates that the rate of CKD progression can be lowered by pharmacological interventions. Nephroprotective strategies currently focus on the blockade of the renin-angiotensin system. Angiotensin-converting-enzyme inhibitors and angiotensin-receptor blockers provide efficient control not only of blood pressure, but also of proteinuria, an effect associated with improved long-term nephroprotection compared with other antihypertensive drug classes. In addition, evidence for an additional nephroprotective advantage of tight blood-pressure control towards the low-normal range in young patients and patients with proteinuria is emerging. In this Review, we describe the role of hypertension in CKD and discuss the therapeutic principle of the prevention of CKD progression with antihypertensive agents.

Citing Articles

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Cardiovascular Autonomic Dysfunction in Chronic Kidney Disease: a Comprehensive Review.

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