Key result
Initiate diuretics or RAS inhibitors as first-line therapy in African Americans with proteinuric hypertensive CKD.
Highlights the importance of screening and prompt therapy to mitigate the rapid progression of hypertensive chronic kidney disease in African Americans.
African Americans have a disproportionate burden of chronic kidney disease (CKD), which tends to have an earlier onset and a more rapid progression in this population. Many of the factors responsible for the rapid progression of CKD in African Americans are detectable by screening and are modifiable with prompt therapy.
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Martins et al. (2012) conducted a review in Hypertensive chronic kidney disease. Antihypertensive therapy (renin-angiotensin system inhibitors and diuretics) was evaluated. African Americans with hypertensive chronic kidney disease and proteinuria should receive a diuretic, a renin-angiotensin system inhibitor, or both as initial therapy, with a target blood pressure of less than 130/80 mm Hg.
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