[Treatment of hypertension in chronic kidney disease]

Area of Science:

• Nephrology
• Cardiology
• Pharmacology

Context:

• Hypertension is a major risk factor for chronic kidney disease (CKD) progression and cardiovascular events.
• CKD patients often present complex comorbidities requiring tailored treatment approaches.
• Renal replacement therapy (RRT) is a significant burden, necessitating strategies to delay its onset.

Purpose:

• To outline optimal hypertension management strategies for patients with chronic kidney disease.
• To highlight the importance of nephroprotection and cardiovascular risk reduction in CKD.
• To guide the selection of antihypertensive medications and combinations based on individual patient factors.

Summary:

• Adequate blood pressure control in CKD reduces cardiovascular complications and slows renal failure progression.
• Non-pharmacological methods like salt restriction are important, often combined with antihypertensive medications.
• Key drug classes include renin-angiotensin-aldosterone (RAA) system inhibitors and diuretics, with combination choice dependent on proteinuria, renal function, and volume status.

Impact:

• Improved patient outcomes through reduced cardiovascular events and delayed progression of renal failure.
• Enhanced nephroprotection, potentially delaying the need for renal replacement therapy.
• Personalized treatment approaches leading to better blood pressure control and reduced disease burden in CKD patients.