Recent advances in the management of secondary hypertension: chronic kidney disease

Area of Science:

• Nephrology
• Cardiology
• Pharmacology

Background:

• Hypertension is a common comorbidity in chronic kidney disease (CKD), significantly increasing the risk of end-stage renal disease (ESRD), cardiovascular disease (CVD), and mortality.
• Effective blood pressure (BP) management in CKD patients is essential for mitigating both CVD and ESRD progression.

Purpose of the Study:

• To outline the 2018 Japanese Society of Nephrology (JSN CKD 2018) guidelines for target BP and pharmacological interventions in CKD.
• To review recent advancements in managing hypertension within the context of CKD.

Main Methods:

• Review of evidence-based clinical practice guidelines (JSN CKD 2018).
• Discussion of emerging pharmacological options including sodium-glucose cotransporter (SGLT) 2 inhibitors, mineralocorticoid receptor blockers, and renal denervation.

Main Results:

• The guidelines provide recommendations for target BP and drug choices in CKD patients.
• SGLT2 inhibitors represent a novel class of antihypertensives with potential cardiorenal protective effects due to their body fluid volume regulation and diuretic actions.

Conclusions:

• Optimal BP control is paramount in CKD management to prevent ESRD and CVD.
• SGLT2 inhibitors show promise as a new therapeutic strategy for hypertension in CKD, potentially offering significant cardiorenal benefits.