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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

Hypertension management in patients with chronic kidney disease

Biff F Palmer1

  • 1Department of Medicine, Division of Nephrology, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA. biff.palmer@utsouthwestern.edu

Current Hypertension Reports
|September 9, 2008
PubMed

Insights

Hypertension accelerates chronic kidney disease (CKD). Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers slow CKD progression, but optimal dosing and management of side effects require further study.

Area of Science:

  • Nephrology
  • Cardiovascular Medicine
  • Pharmacology

Background:

  • Hypertension is a primary driver of chronic kidney disease (CKD) progression.
  • Renal dysfunction impairs blood pressure regulation, increasing kidney damage risk.
  • Renin-angiotensin system inhibitors show promise in slowing CKD, independent of blood pressure reduction.

Purpose of the Study:

  • To evaluate the efficacy of different doses and combinations of renin-angiotensin system inhibitors for renal protection in CKD patients.
  • To investigate the role of urinary protein excretion in monitoring and guiding antihypertensive therapy for maximal renal benefit.
  • To assess the management strategies for complications like serum creatinine increase and hyperkalemia during antihypertensive treatment.

Main Methods:

  • Review of existing literature on hypertension and CKD.
  • Analysis of clinical trial data on angiotensin-converting enzyme inhibitors and angiotensin receptor blockers.
  • Monitoring of urinary protein excretion and serum creatinine levels as therapeutic indicators.

Main Results:

  • Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers demonstrate renoprotective effects beyond blood pressure control.
  • Urinary protein excretion serves as a key marker for assessing therapeutic response and adjusting medication.
  • Serum creatinine elevation and hyperkalemia are manageable complications, allowing continued renin-angiotensin blockade.

Conclusions:

  • Optimizing renin-angiotensin system blockade is crucial for slowing CKD progression.
  • Close monitoring of urinary protein and management of side effects are essential for effective treatment.
  • Further research is needed to establish optimal therapeutic regimens for renal protection in hypertensive CKD patients.

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