Julian Segura1, Luis M Ruilope. 1. Hypertension Unit, Nephrology Department, Hospital 12 de Octubre, Madrid 28041, Spain.
Abstract
PURPOSE OF REVIEW: This review focuses on the need for combined antihypertensive therapy drugs in patients with chronic kidney disease and the relevance of diuretics. RECENT FINDINGS: Chronic kidney disease is a high-risk situation characterized by the presence of volume overload-related hypertension, micro/macroalbuminuria and other traditional and nontraditional risk factors. To achieve the blood pressure goal in these patients, combined antihypertensive therapy (including diuretics) is usually required. SUMMARY: Extracellular volume expansion is an important, if not the most important, contributing factor to hypertension seen in chronic kidney disease. Protection against progression of renal dysfunction has two main requirements: strict blood pressure control and lowering proteinuria to values as near to normal as possible. Diuretics have been a useful tool to manage volume overload and to achieve strict blood pressure control in patients with chronic kidney disease. Albeit other blood pressure-lowering agents offer additional favorable effects independently of blood pressure changes, diuretics will continue to be used in these patients.
PURPOSE OF REVIEW: This review focuses on the need for combined antihypertensive therapy drugs in patients with chronic kidney disease and the relevance of diuretics. RECENT FINDINGS:Chronic kidney disease is a high-risk situation characterized by the presence of volume overload-related hypertension, micro/macroalbuminuria and other traditional and nontraditional risk factors. To achieve the blood pressure goal in these patients, combined antihypertensive therapy (including diuretics) is usually required. SUMMARY: Extracellular volume expansion is an important, if not the most important, contributing factor to hypertension seen in chronic kidney disease. Protection against progression of renal dysfunction has two main requirements: strict blood pressure control and lowering proteinuria to values as near to normal as possible. Diuretics have been a useful tool to manage volume overload and to achieve strict blood pressure control in patients with chronic kidney disease. Albeit other blood pressure-lowering agents offer additional favorable effects independently of blood pressure changes, diuretics will continue to be used in these patients.
Authors: Tamara Isakova; Cheryl A M Anderson; Mary B Leonard; Dawei Xie; Orlando M Gutiérrez; Leigh K Rosen; Jacquie Theurer; Keith Bellovich; Susan P Steigerwalt; Ignatius Tang; Amanda Hyre Anderson; Raymond R Townsend; Jiang He; Harold I Feldman; Myles Wolf Journal: Nephrol Dial Transplant Date: 2011-03-07 Impact factor: 5.992
Authors: Mahboob Rahman; Charles E Ford; Jeffrey A Cutler; Barry R Davis; Linda B Piller; Paul K Whelton; Jackson T Wright; Joshua I Barzilay; Clinton D Brown; Pedro J Colon; Lawrence J Fine; Richard H Grimm; Alok K Gupta; Charles Baimbridge; L Julian Haywood; Mario A Henriquez; Ekambaram Ilamaythi; Suzanne Oparil; Richard Preston Journal: Clin J Am Soc Nephrol Date: 2012-04-05 Impact factor: 8.237