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Related Concept Videos

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
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Multiple classes of antihypertensive medications are employed in treating hypertension. The most commonly recommended first-line treatments include:Thiazide Diuretics, such as chlorthalidone, increase sodium and water excretion from the body, reducing blood volume and blood pressure.Angiotensin-converting enzyme inhibitors, like lisinopril, block the conversion of angiotensin I to II, a potent vasoconstrictor lowering blood pressure.Angiotensin II Receptor Blockers (ARBs) prevent angiotensin II...
Chronic Kidney Disease III: Interprofessional Care01:28

Chronic Kidney Disease III: Interprofessional Care

Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
Antihypertensive Drugs: Potassium-Sparing Diuretics01:28

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Liddle syndrome is a genetically inherited form of hypertension characterized by the overactivity of epithelial sodium channels in the nephron, the functional unit of the kidney. This heightened activity leads to increased sodium reabsorption and excessive excretion of potassium. To counteract this, potassium-sparing diuretics such as amiloride are used. They function by blocking these sodium channels, thereby reducing the influx of sodium into the epithelial cells and minimizing the loss of...
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Updated: Jul 14, 2026

Improved Home Blood Pressure Control by CT-guided Ozone-mediated Renal Denervation for Patients with Resistant Hypertension
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Published on: June 6, 2025

[Which optimal antihypertensive bitherapy for kidney patients?].

Jean-François Bonne1, Irina Shahapuni, Sébastien Mailliez

  • 1Service de néphrologie, CHU d'Amiens, hôpital Sud, avenue René-Laennec, 80054 Amiens cedex 01, France.

Nephrologie & Therapeutique
|June 2, 2007
PubMed
Summary

Optimal antihypertensive treatment for chronic kidney disease (CKD) involves a combination of diuretics and angiotensin AT1-receptor inhibitors, especially for patients with macroproteinuria. Individualized treatment is crucial, considering cardiovascular risks and drug tolerance.

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Last Updated: Jul 14, 2026

Improved Home Blood Pressure Control by CT-guided Ozone-mediated Renal Denervation for Patients with Resistant Hypertension
04:37

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Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion
08:35

Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion

Published on: May 26, 2022

Area of Science:

  • Nephrology
  • Cardiology
  • Pharmacology

Context:

  • Chronic kidney disease (CKD) patients face a higher incidence of cardiovascular complications than end-stage renal disease.
  • Existing research presents conflicting views on whether antihypertensive drugs primarily lower blood pressure or have intrinsic organ-specific effects.
  • The optimal blood pressure target for CKD patients remains a subject of debate.

Purpose:

  • To review the optimal antihypertensive treatment strategies for patients with chronic kidney disease (CKD).
  • To address the controversy surrounding the mechanisms of cardiovascular and renal protection by antihypertensive medications.
  • To propose a preferred therapeutic regimen based on current evidence.

Summary:

  • The review favors a combination therapy of hypokalemic diuretics (thiazides and/or loop diuretics) with angiotensin AT1-receptor inhibitors (ACE inhibitors or ARBs) for CKD patients, particularly those with macroproteinuria.
  • This bitherapy is recommended over dihydropyridine and diuretic combinations due to diuretics' proven benefits in preventing heart failure and stroke, and their long-lasting antihypertensive effect.
  • Beta-blockers are discouraged as first-line treatment due to their diabetogenic effects, reserved for specific cardiac indications or as alternatives to ACE inhibitors/ARBs.
  • Angiotensin AT1-receptor blockers (ARBs) may offer better cerebral protection than ACE inhibitors, pending further study results.

Impact:

  • Provides a clear therapeutic recommendation for managing hypertension in CKD patients, prioritizing cardiovascular and renal protection.
  • Highlights the importance of considering both blood pressure-lowering effects and intrinsic drug properties in treatment selection.
  • Emphasizes the need for individualized treatment plans, accounting for comorbidities, drug tolerance, and cost.