The attributable burden of hypertension: focus on CKD

Hypertension is a worldwide risk factor for premature death and disability from heart disease, stroke, peripheral vascular disease, and kidney failure. Much is known about the role of elevated blood pressure as a contributor to diseases of the heart and brain, but the risk it confers specifically to the development and progression of kidney disease is less well appreciated. The kidney is unique among the target organs of elevated blood pressure because it both suffers damage and still contributes to the pathophysiologic sustenance of hypertension through many avenues. In this overview, we discuss high blood pressure from an epidemiologic standpoint, placing it in a nephrologic perspective and discuss some of the known and speculative mechanisms that link it to kidney damage.