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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 and kidney disease: what do the data really show?

Debbie L Cohen1, Raymond R Townsend

  • 1Department of Medicine, Renal, Electrolyte and Hypertension Division, University of Pennsylvania, Philadelphia, PA 19104, USA. debbie.cohen@uphs.upenn.edu

Current Hypertension Reports
|July 21, 2012
PubMed

Insights

For patients with chronic kidney disease (CKD), a blood pressure (BP) goal of less than 140/90 mm Hg is recommended. Current evidence does not strongly support lower BP targets for preventing kidney disease progression.

Area of Science:

  • Nephrology
  • Cardiology
  • Internal Medicine

Background:

  • Hypertension is a common comorbidity in chronic kidney disease (CKD), significantly increasing cardiovascular disease (CVD) risk.
  • Previous guidelines suggested lower blood pressure (BP) targets (<130/80 mm Hg) for CKD patients due to high CVD risk.
  • The direct link between reduced proteinuria and improved kidney outcomes from lower BP targets remains unclear.

Purpose of the Study:

  • To evaluate the optimal blood pressure (BP) target for patients with chronic kidney disease (CKD).
  • To review current evidence regarding the benefits of lower BP targets in CKD management.
  • To provide a BP management recommendation for CKD patients based on available data.

Main Methods:

  • Review of existing clinical studies and guidelines on BP management in CKD.
  • Analysis of data linking BP control, proteinuria, and kidney outcomes.
  • Consideration of ongoing research into optimal BP targets for CKD.

Main Results:

  • Suggestive data indicates potential benefits of lower BP in CKD patients with proteinuria.
  • Studies have not definitively established a direct causal relationship between treatment-induced proteinuria reduction and improved kidney outcomes.
  • Ongoing research is expected to provide further insights into BP targets for CKD.

Conclusions:

  • Based on current evidence, a recommended BP goal for all patients with CKD is less than 140/90 mm Hg.
  • Lower BP targets (<130/80 mm Hg) require further investigation to confirm benefits in kidney outcomes.
  • Further research is needed to establish definitive BP targets for CKD progression and cardiovascular risk reduction.

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