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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

[Treating high blood pressure in kidney patients: evidence and implications]

R Marín1, M Gorostidi, R Alvarez-Navascués

  • 1Servicio de Nefrología, Unidad de Hipertensión, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain. rmarini@hca.es

Medicina Clinica
|May 23, 2009
PubMed

Insights

To slow chronic kidney disease (CKD) progression, control blood pressure and reduce urinary protein. While dual blockade therapy reduces protein excretion, intensified multifactorial interventions are crucial for managing advanced CKD and preventing complications.

Area of Science:

  • Nephrology
  • Cardiovascular Medicine

Context:

  • Chronic kidney disease (CKD) affects millions globally, with significant morbidity and mortality.
  • Patients with grade 3 or 4 CKD face high risks of end-stage renal disease and cardiovascular events.

Purpose:

  • To outline current strategies for delaying CKD progression, focusing on blood pressure and proteinuria control.
  • To evaluate the efficacy of dual renin-angiotensin system blockade in renoprotection.
  • To highlight the need for intensified multifactorial interventions in advanced CKD.

Summary:

  • Optimal management of CKD involves strict blood pressure control (<130/80 mmHg) and reducing 24-h urine protein (<0.5 g) or microalbuminuria (<300 mg/g).
  • First-line renoprotective agents include angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers at maximal tolerated doses.
  • Dual blockade with these agents effectively reduces urinary protein excretion but does not consistently delay renal failure progression in high-risk patients.
  • Intensified multifactorial interventions are essential due to the high incidence of premature complications in advanced CKD.

Impact:

  • Findings underscore the limitations of dual blockade in preventing renal failure progression.
  • Emphasizes the critical need for comprehensive, multifactorial treatment strategies in CKD management.
  • Suggests that novel renin-angiotensin system blockade approaches may offer improved outcomes for CKD patients.

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