Treatment of renal failure and blood pressure

Some of the more important advances in slowing progression of renal disease in the past few years include the following: the identification of specific racial groups, such as African-Americans and Mexican-Americans, who are at higher risk for renal disease progression than the general population; the observation that African-Americans may require lower levels of blood pressure reductions (i.e. < 125/75 mmHg) than the general population in order to achieve a similar degree of protection against renal disease progression; the understanding that angiotensin-converting enzyme inhibitors in the early stages of diabetic renal disease and nondihydropyridine calcium-channel blockers in those with established renal insufficiency from diabetes slow renal disease progression and reduce proteinuria; and lastly, aggressive blood pressure reduction in dialysis patients is associated with a reduction in cardiovascular events.