Related Experiment Video
Updated: Jan 29, 2026
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Management of Hypertension in Chronic Kidney Disease
Dan Pugh1,2, Peter J Gallacher1, Neeraj Dhaun3,4
1University/BHF Centre for Cardiovascular Science, The Queen's Medical Research Institute, University of Edinburgh, 47 Little France Crescent, Edinburgh, EH16 4TJ, Scotland, UK.
Insights
Managing hypertension in chronic kidney disease (CKD) requires personalized, evidence-based strategies. Achieving blood pressure targets is crucial for slowing CKD progression and reducing cardiovascular disease (CVD) risk.
Area of Science:
- Nephrology
- Cardiology
- Internal Medicine
Background:
- Chronic kidney disease (CKD) is a growing global health issue, closely linked to cardiovascular disease (CVD).
- Hypertension is a major factor in CKD, affecting most patients and contributing to disease progression and CVD.
- Current guidelines lack consensus on optimal blood pressure (BP) targets for CKD patients.
Purpose of the Study:
- To review the evidence informing hypertension management in CKD.
- To highlight the importance of individualized treatment plans for CKD patients with hypertension.
- To discuss current and future therapeutic approaches for managing hypertension in CKD.
Main Methods:
- Review of existing clinical guidelines and scientific literature on hypertension in CKD.
- Analysis of non-pharmacological and pharmacological treatment strategies.
- Consideration of special populations, including those on haemodialysis and post-kidney transplantation.
Main Results:
- Non-pharmacological interventions offer some BP reduction but are often insufficient alone.
- Combination antihypertensive therapy is frequently necessary to achieve target BP in CKD patients.
- Certain medications offer BP-independent renoprotective and cardioprotective benefits.
Conclusions:
- Optimal BP management in CKD requires a personalized, evidence-based approach.
- Effective hypertension control is vital for slowing CKD progression and mitigating CVD risk.
- Future novel therapies may offer improved treatment options for hypertension in CKD.
Abstract:
Chronic kidney disease (CKD) is an increasingly prevalent condition globally and is strongly associated with incident cardiovascular disease (CVD). Hypertension is both a cause and effect of CKD and affects the vast majority of CKD patients. Control of hypertension is important in those with CKD as it leads to slowing of disease progression as well as reduced CVD risk. Existing guidelines do not offer a consensus on optimal blood pressure (BP) targets. Therefore, an understanding of the evidence used to create these guidelines is vital when considering how best to manage individual patients. Non-pharmacological interventions are useful in reducing BP in CKD but are rarely sufficient to control BP adequately. Patients with CKD and hypertension will often require a combination of antihypertensive medications to achieve target BP. Certain pharmacological therapies provide additional BP-independent renoprotective and/or cardioprotective action and this must be considered when instituting therapy. Managing hypertension in the context of haemodialysis and following kidney transplantation presents further challenges. Novel therapies may enhance treatment in the near future. Importantly, a personalised and evidence-based management plan remains key to achieving BP targets, reducing CVD risk and slowing progression of CKD.
Related Concept Videos
01:18Chronic Kidney Disease IV: Nursing Management
01:25Chronic Kidney Disease I: Introduction
01:24Chronic Kidney Disease II: Clinical Manifestations
01:29Chronic Obstructive Pulmonary Disease-V: Management
Smoking Cessation
01:28Chronic Kidney Disease III: Interprofessional Care
01:30Chronic Obstructive Pulmonary Disease-V: Nursing Management
Assessment