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Hypertension and kidney disease progression
Clinical Nephrology
|September 25, 2019
Insights
Hypertension frequently occurs in chronic kidney disease (CKD) and accelerates its progression. Genetic factors, like APOL1 gene variants in African Americans, may influence the risk of hypertension-attributed nephropathy.
Area of Science:
- Nephrology
- Genetics
- Cardiovascular Medicine
Background:
- Hypertension is a prevalent comorbidity in patients with chronic kidney disease (CKD).
- Hypertension is a major risk factor for CKD progression and a leading cause of kidney failure.
- Hypertensive nephropathy, a significant contributor to CKD, is often diagnosed clinically, leaving many cases of unknown etiology.
Purpose of the Study:
- To highlight the association between hypertension and CKD progression.
- To discuss the diagnostic challenges of hypertensive nephropathy.
- To explore the genetic underpinnings of hypertension-attributed nephropathy, particularly the role of APOL1 variants.
Main Methods:
- Review of existing literature on hypertension in CKD.
- Clinical diagnostic criteria for hypertensive nephropathy.
- Genetic association studies, focusing on APOL1 gene variants in relevant populations.
Main Results:
- Hypertension is strongly linked to the progression of chronic kidney disease.
- Hypertensive nephropathy represents a substantial portion of CKD cases with initially unknown causes.
- Evidence suggests a genetic predisposition to hypertension-attributed nephropathy, notably linked to APOL1 risk variants in African Americans.
Conclusions:
- Hypertension is a critical factor in CKD progression and a common cause of hypertensive nephropathy.
- Genetic factors, including APOL1 variants, play a significant role in the susceptibility and progression of hypertension-related kidney disease.
- Further research into genetic determinants may improve diagnosis and management strategies for hypertensive nephropathy.
Abstract:
Hypertension is a common finding in patients with chronic kidney disease (CKD) and it is associated with kidney disease progression. Hypertensive nephropathy is a diagnosis, mostly based on clinical suspicion and defines many cases of CKD of unknown etiology. The risk of progression of hypertension-attributed nephropathy seems to have a genetic background as has been demonstrated in African-American patients with APOL1 gene risk variants.
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