The impact of antihypertensives on kidney disease

F1000Res. 2017 May 2:6:611. doi: 10.12688/f1000research.9916.1. eCollection 2017.

Abstract

Arterial hypertension and chronic kidney disease (CKD) are intimately related. The control of blood pressure (BP) levels is strongly recommended in patients with CKD in order to protect the kidney against the accompanying elevation in global cardiovascular (CV) risk. Actually, the goal BP in patients with CKD involves attaining values <140/90 mmHg except if albuminuria is present. In this case, it is often recommended to attain values <130/80 mmHg, although some guidelines still recommend <140/90 mmHg. Strict BP control to values of systolic BP around 120 mmHg was recently shown to be safe in CKD according to data from the SPRINT trial, albeit more data confirming this benefit are required. Usually, combination therapy initiated with an angiotensin receptor blocker (ARB) or angiotensin-converting enzyme inhibitor (ACEi) and commonly followed by the addition of a calcium channel blocker and a diuretic is needed. Further studies are required as well as new drugs in particular after the positive data obtained from new oral anti-diabetic drugs.

Keywords: CKD; antihypertensives; arterial hypertension; chronic kidney disease; kidney disease.

Publication types

  • Review

Grants and funding

This article was written with the help of Instituto de Salud Carlos III, projects PI14/01841 and CP15/0129, Fundación Senefro, and Fondos FEDER.