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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

Effect of blood pressure lowering on markers of kidney disease progression

Suneel M Udani1, Jay L Koyner

  • 1Section of Nephrology, University of Chicago, Chicago, IL 60637, USA.

Current Hypertension Reports
|September 10, 2009
PubMed

Insights

Hypertension management for chronic kidney disease (CKD) lacks ideal blood pressure targets. Focusing on proteinuria shows promise, but novel kidney injury markers are needed for optimal antihypertensive therapy in CKD patients.

Area of Science:

  • Nephrology
  • Cardiology
  • Internal Medicine

Background:

  • Hypertension is a major cause and comorbidity of chronic kidney disease (CKD).
  • The increasing prevalence of CKD necessitates identifying modifiable risk factors for its progression.
  • Current evidence on aggressive blood pressure control for slowing CKD progression is inconclusive regarding optimal targets.

Purpose of the Study:

  • To explore the role of proteinuria as a therapeutic target in slowing CKD progression.
  • To highlight the limitations of current markers like proteinuria and estimated glomerular filtration rate (eGFR) in assessing kidney injury.
  • To emphasize the need for novel biomarkers to guide antihypertensive therapy in CKD.

Main Methods:

  • Review of existing data on blood pressure targets in CKD.
  • Analysis of studies focusing on proteinuria as a marker of kidney damage and therapeutic goal.
  • Discussion on the utility of novel kidney injury markers.

Main Results:

  • Aggressive blood pressure control has not definitively established ideal targets for slowing CKD.
  • Targeting proteinuria shows potential in mitigating CKD progression.
  • Proteinuria and declining eGFR may indicate irreversible kidney damage, limiting therapeutic impact.

Conclusions:

  • Optimal blood pressure targets for hypertension in CKD remain uncertain.
  • Proteinuria is a promising, yet potentially late, marker for guiding antihypertensive therapy.
  • Novel kidney injury markers are crucial for refining antihypertensive strategies and improving outcomes in CKD.

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