Development of chronic kidney disease in essential hypertension during long-term therapy

PURPOSE OF REVIEW: This review examines the relevance of the development of chronic kidney disease in long-term hypertensive patients on the cardiovascular prognosis. RECENT FINDINGS: Recently published guidelines recognize the relevance of the development of chronic kidney disease in the stratification of risk for the hypertensive patient. An adequate assessment of renal function, including an estimation of the glomerular filtration rate, is mandatory in order to ensure an adequate evaluation of the global cardiovascular risk in the hypertensive patient. The presence of subtle elevations in serum creatinine concentrations is a potent predictor of a poor cardiovascular prognosis. The clustering of associated risk factors seems to justify the elevated cardiovascular risk observed in patients with essential hypertension and mild renal function derangement. SUMMARY: Chronic kidney disease is associated with a significant increase in cardiovascular risk attributable to the simultaneous existence of other risk factors related to the metabolic syndrome. The high prevalence of chronic kidney disease in the general and hypertensive populations forces the recognition of its relevance and the need for an integrated therapeutic approach simultaneously to protect the renal and cardiovascular systems fully.