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Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

The role of the kidney in cardiovascular medicine

Eberhard Ritz1

  • 1Department Internal Medicine (Nierenklinik), Ruperto Carola University, Bergheimer Str. 56 a, D-69115 Heidelberg, Germany, FRG. Prof.E.Ritz@t-online.de

European Journal of Internal Medicine
|September 3, 2005
PubMed

Insights

Kidney disease causes hypertension, while high blood pressure worsens kidney function. Recent research highlights mechanisms like altered sodium excretion and the renin-angiotensin system, advocating for lower blood pressure targets in kidney patients.

Area of Science:

  • Nephrology
  • Cardiovascular Medicine
  • Hypertension Research

Background:

  • The kidney plays a dual role in hypertension, acting as both a cause and a victim.
  • Renal disease and structural abnormalities can initiate or exacerbate hypertension.
  • Elevated blood pressure, even within the normotensive range, accelerates renal function decline in primary kidney disease.

Purpose of the Study:

  • To review recent advancements in understanding the complex interplay between renal function and hypertension.
  • To emphasize the multifactorial mechanisms underlying renal hypertension.
  • To highlight revised blood pressure targets for patients with kidney disease.

Main Methods:

  • Review of current scientific literature on renal hypertension.
  • Analysis of physiological mechanisms involved in blood pressure regulation and kidney function.
  • Examination of updated clinical guidelines and treatment targets.

Main Results:

  • Multiple mechanisms contribute to renal hypertension, including altered blood pressure natriuresis, renin-angiotensin system activation, sympathetic nervous system overactivity, and impaired vasodilation.
  • Existing recommendations for blood pressure targets in renal patients have been substantially revised.
  • Lowering blood pressure to below 125/75 mm Hg is now recommended for patients with kidney disease.

Conclusions:

  • The relationship between the kidney and hypertension is intricate, involving bidirectional influences.
  • Effective management of renal hypertension requires addressing multiple pathophysiological pathways.
  • Achieving lower blood pressure targets and reducing proteinuria are crucial for preserving renal function.

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