Antihypertensive management in chronic kidney disease requires multiple drug classes including a diuretic, though the optimal blood pressure target remains undetermined.
What are the causes and treatment strategies for hypertension in patients with chronic kidney disease?
Management of hypertension in chronic kidney disease requires multi-drug regimens including diuretics to address volume expansion and achieve lower blood pressure targets.
Chronic kidney disease is both a cause and a consequence of hypertension. Extracellular volume expansion is an important, if not the most important, contributing factor to hypertension seen in chronic kidney disease. Beyond volume expansion, chronic kidney disease-related hypertension is without truly defining characteristics. Consequently, the sequencing of antihypertensive medications for the patient with chronic kidney disease and hypertension becomes arbitrary. Prescription practice in such patients should be mindful of the need for multiple drug classes with at least one of them being a diuretic. Blood pressure goals in the patient with chronic kidney disease and hypertension are set at lower levels than those for patients with essential hypertension alone. It remains to be determined to what level blood pressure should be lowered in the patient with chronic kidney disease, however.
Domenic A. Sica (Tue,) conducted a review in Chronic kidney disease and hypertension. Antihypertensive medications was evaluated. Antihypertensive management in chronic kidney disease requires multiple drug classes including a diuretic, though the optimal blood pressure target remains undetermined.