Hypertension Management in Patients with Chronic Kidney Disease

Methodist Debakey Cardiovasc J. 2022 Sep 6;18(4):41-49. doi: 10.14797/mdcvj.1119. eCollection 2022.

Abstract

Hypertension and chronic kidney disease are closely linked. Patients with chronic kidney disease have hypertension almost universally and uncontrolled hypertension accelerates the decline in kidney function. The pathophysiology of hypertension in chronic kidney disease is complex, but is largely related to reduced nephron mass, sympathetic nervous system overactivation, involvement of the renin-angiotensin-aldosterone system, and generalized endothelial dysfunction. Consensus guidelines for blood pressure targets have adopted a blood pressure <120/80 mm Hg in native chronic kidney disease and <130/80 mm Hg in kidney transplant recipients. Guidelines also strongly advocate for renin-angiotensin-aldosterone system blockade as the first-line therapy.

Keywords: ambulatory blood pressure monitor; chronic kidney disease; hypertension; masked hypertension.

Publication types

  • Review

MeSH terms

  • Blood Pressure
  • Humans
  • Hypertension* / diagnosis
  • Hypertension* / drug therapy
  • Hypertension* / epidemiology
  • Kidney
  • Renal Insufficiency, Chronic* / complications
  • Renal Insufficiency, Chronic* / diagnosis
  • Renal Insufficiency, Chronic* / epidemiology
  • Renin-Angiotensin System
  • Sympathetic Nervous System