Aggressive blood pressure control with renin-angiotensin axis blockers is recommended in chronic kidney disease for nephroprotective and cardioprotective benefits.
Supports lower BP targets in CKD with proteinuria; leaves open confirmation via dedicated RCTs before practice change.
The kidney could be the cause of essential hypertension which can also cause renal disease. High blood pressure is also very common in chronic kidney disease, and is moreover a well-known risk factor for a faster progression of kidney failure. Hypertension and kidneys are thus closely linked. Hypertension must be aggressively treated in patients suffering from chronic kidney disease, with a blood pressure goal of less than 130/80 mmHg, even lower than 125/75 mmHg when proteinuria is over 1g/day, using optimal and effective antihypertensive drugs. Among them, the blockers of the renin-angiotensin axis offer nephroprotective but also cardioprotective properties beyond their effect on blood pressure.
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Krzesinski et al. (2007) studied this question.
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