[HYPERTENSION AS A CAUSE OF RENAL DISEASE - FACT OR FICTION?]

The possible link between hypertension and chronic kidney disease has been preoccupying the medical world for over a century. The cause-effect relationship between malignant hypertension and renal disease is clear and agreed upon, but when hypertension is at milder levels, this relationship becomes blurred. Does indeed non-malignant hypertension also cause kidney disease that can lead to end-stage kidney failure? In this review, we provide evidence based primarily on epidemiologic data, from which it can be concluded that the higher the blood pressure is, starting from normal blood pressure and above, the higher is the risk of developing kidney disease and loss of renal function. Does treatment of hypertension prevent kidney injury secondary to hypertension? The evidence points to the issue that hypertension slows down the rate of decline in glomerular filtration rate, but only in the presence of significant urinary protein excretion, whereas in the absence of proteinuria, lowering blood pressure has no effect on the development of hypertensive renal disease.