[Antihypertensive therapy in renal failure]

Hypertension can be a cause as well as a consequence of renal disease. Fluid overload or activation of the renin angiotensin system by glomerular ischemia leads to an elevation of systemic blood pressure in acute as well as chronic renal disease. Furthermore in the latter disorder an increased activity of the sympathetic nervous system as well as metabolic disorders contribute to hypertension. Accordingly antihypertensive therapy in patients with renal insufficiency is diverse. Additionally in chronic kidney disease one has to consider the variable effects of different antihypertensive drugs on intrarenal hemodynamics.