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Related Experiment Video

Updated: Mar 26, 2026

5/6th Nephrectomy in Combination with High Salt Diet and Nitric Oxide Synthase Inhibition to Induce Chronic Kidney Disease in the Lewis Rat
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Hypertension in Chronic Glomerulonephritis.

Chun-Gyoo Ihm1

  • 1Division of Nephrology, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Korea.

Electrolyte & Blood Pressure : E & BP
|February 6, 2016
PubMed
Summary

Hypertension in chronic glomerulonephritis (GN) is mainly due to increased blood volume and RAAS overactivity. Lowering blood pressure targets and using RAAS blockers, calcium channel blockers, and diuretics can manage hypertension and reduce proteinuria in GN patients.

Keywords:
Chronic glomerulonephritisRAAS blockadeVolume dependent

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Area of Science:

  • Nephrology
  • Cardiovascular Medicine

Background:

  • Chronic glomerulonephritis (GN) significantly elevates hypertension risk.
  • Hypertension in GN is primarily volume-dependent, independent of renal function decline.
  • Renal damage and ischemia in GN activate the intrarenal renin-angiotensin-aldosterone system (RAAS) and sympathetic nervous system, contributing to elevated blood pressure.

Purpose of the Study:

  • To review the mechanisms of hypertension in chronic GN.
  • To discuss current KDIGO guidelines for blood pressure targets in CKD patients.
  • To evaluate therapeutic strategies for managing hypertension and proteinuria in chronic GN.

Main Methods:

  • Literature review of studies on chronic glomerulonephritis and hypertension.
  • Analysis of KDIGO guidelines for blood pressure management in chronic kidney disease.
  • Synthesis of evidence on the role of RAAS, sympathetic nervous system, and therapeutic interventions.

Main Results:

  • Hypertension in chronic GN is linked to volume overload, salt sensitivity, arteriolosclerosis, and RAAS/sympathetic overactivity.
  • KDIGO guidelines suggest BP targets of ≤140/90 mmHg for CKD without albuminuria and ≤130/80 mmHg for those with albuminuria (≥30mg/24h).
  • RAAS blockade is recommended for patients with albuminuria; combination therapy with calcium channel blockers and diuretics may improve BP control and reduce proteinuria.

Conclusions:

  • Hypertension in chronic GN is multifactorial, involving volume, RAAS, and sympathetic tone.
  • Tailored BP targets and RAAS-blocking agents are crucial for managing hypertension in chronic GN.
  • Combination therapy offers a promising approach to achieve BP goals and mitigate proteinuria in this patient population.