Guidelines for the management of hypertension in CKD patients: where do we stand in 2024?

Area of Science:

• Nephrology
• Cardiology
• Hypertension Management

Background:

• Previous guidelines for hypertension in chronic kidney disease (CKD) had key disagreements.
• The European Society of Hypertension (ESH) released new 2023 guidelines, endorsed by the European Renal Association.

Purpose of the Study:

• To summarize and comment on the key points of the 2023 ESH hypertension guidelines for CKD patients.
• To compare and highlight differences between the 2023 ESH and 2021 Kidney Disease: Improving Global Outcomes (KDIGO) guidelines.

Main Methods:

• Review of the 2023 ESH Guidelines for the management of arterial hypertension.
• Comparative analysis of the 2023 ESH guidelines against the 2021 KDIGO guidelines for blood pressure management in CKD.
• Synthesis of novel recommendations and areas of emphasis.

Main Results:

• The 2023 ESH guidelines present novel recommendations for hypertension in CKD.
• These guidelines largely align with 2021 KDIGO guidelines but offer different emphasis on topics like antihypertensive agent use.
• Recent evidence has influenced the evolution of these recommendations.

Conclusions:

• The 2023 ESH guidelines represent an update reflecting the latest evidence-based practices for hypertension in CKD.
• Understanding the nuances and differences between ESH and KDIGO guidelines is crucial for optimal patient care.
• These guidelines aim to harmonize management strategies for hypertension in CKD patients.