Hypertension and renal insufficiency: recognition and management

The incidence of end-stage renal disease among hypertensive patients is increasing. Early recognition of renal insufficiency is critically important, since reversible causes of renal failure, such as urinary tract obstruction and renal artery stenosis, may be identified and corrected. Control of hypertension slows the progression of renal failure. Once renal failure develops, special attention must be given to diet and drug therapy.