Key result
RAS inhibitor-based BP control provides vital cardiovascular and renal protection in CKD.
Why the study?
Cardiovascular disease is a major cause of morbidity and mortality in patients with chronic kidney disease, and blood pressure control aims to prevent CVD and provide renoprotection.
In patients with CKD, blood pressure should be controlled to <130/80 mm Hg (or 125/75 mm Hg if proteinuria >1 g/day) using ACE inhibitors or ARBs as first-line agents to prevent cardiovascular disease and provide renoprotection.
May inform individualized BP targets in CKD; leaves open whether specific strategies alter reciprocal CVD-kidney risk.
for more than 3 months. Kidney damage is defined as pathological abnormalities or markers of damage, including abnormalities in blood or urine tests or imaging studies. CKD is classified as stage 1 to 5 on the basis of eGFR. Cardiovascular disease (CVD) carries a reciprocal risk of loss of kidney function in patients with chronic kidney disease (CKD) and with the development of kidney disease. CVD is a major cause of morbidity and mortality in patients with CKD. Blood pressure control in patients with CKD aims to prevent CVD and provide renoprotection. The renin-angiotensin system (RAS) is involved in every stage of the progression of CKD and is, therefore, a critical link in the pathologic relationship between hypertension and renal disease. The first-line agents for controlling blood pressure are inhibitors of the RAS: angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers. These agents have been shown to have renoprotective effects in addition to their ability to control blood pressure. In CKD, the target blood pressure is less than 130/80 mm Hg, or 125/75 mm Hg, if amount of urinary protein is more than 1 g/day. To achieve the target blood pressure, other classes of antihypertensive agents, such as diuretics and calcium channel blockers, should be administered in addition to angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers.
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Utsumi et al. (2012) conducted a review in Chronic Kidney Disease and Hypertension. Blood pressure control (ACEIs, ARBs) was evaluated. Blood pressure control in patients with chronic kidney disease, primarily using renin-angiotensin system inhibitors, is essential to prevent cardiovascular disease and provide renoprotection.
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