Antihypertensive therapy and renal function

Although renal abnormalities may be present in patients with untreated, newly diagnosed essential hypertension, predictors of the development of progressive renal failure are of great concern. In addition, unanswered questions are the final arterial pressure achieved during treatment as well as the ideal renal- and cardiovascular-protective drug therapy. Most antihypertensive agents given for periods of several months in monotherapy have no consistent effect on renal function and hemodynamics. However, they may differ with regard to their influence on other factors considered to be markers of significant impact of hypertension on the kidney, such as albuminuria. Studies of very long-term therapy on the evolution of renal function and using reliable indicators of the variation of glomerular filtration rate are needed.