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Resistant Hypertension and Chronic Kidney Disease: a Dangerous Liaison

Martin J Wolley1,2, Michael Stowasser3

  • 1Endocrine Hypertension Research Centre, Greenslopes and Princess Alexandra Hospitals, University of Queensland School of Medicine, Ipswich Road, Woolloongabba, Brisbane, 4102, Australia. m.wolley@uq.edu.au.

Current Hypertension Reports
|April 14, 2016
PubMed

Insights

Treatment-resistant hypertension is a significant issue in chronic kidney disease (CKD) patients, increasing risks for kidney and heart problems. Accurate diagnosis and management, including diet and medication adherence, are crucial for better outcomes.

Area of Science:

  • Nephrology
  • Cardiology
  • Hypertension Research

Background:

  • Treatment-resistant hypertension (TRH) is prevalent in chronic kidney disease (CKD) patients.
  • TRH in CKD is linked to increased risks of adverse renal and cardiovascular events.
  • Accurate blood pressure monitoring, including out-of-office measurements, is vital for diagnosing TRH in CKD due to masked hypertension.

Purpose of the Study:

  • To review the epidemiology, pathogenesis, and consequences of TRH in CKD.
  • To outline optimal diagnostic approaches for TRH in CKD patients.
  • To discuss evidence-based management strategies for TRH in the context of CKD.

Main Methods:

  • Literature review focusing on resistant hypertension and chronic kidney disease.
  • Analysis of current evidence regarding diagnosis and treatment strategies.
  • Synthesis of epidemiological, pathogenetic, and outcome data.

Main Results:

  • Resistant hypertension is common in CKD and associated with poor outcomes.
  • Accurate blood pressure measurement is key for diagnosis in CKD.
  • Management involves dietary sodium restriction, improved medication adherence, and tailored antihypertensive therapy, particularly diuretics.

Conclusions:

  • TRH in CKD requires specific diagnostic and management considerations.
  • Effective management can mitigate renal and cardiovascular risks.
  • A comprehensive approach addressing adherence, diet, and medication is essential.

Keywords:
CKDChronic kidney diseaseResistant hypertension

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