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Hypertension Management in Patients with Chronic Kidney Disease
Authors:Sean A. Hebert  Hassan N. Ibrahim
Affiliation:1.Department of Surgery, Division of Immunology and Organ Transplantation, The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas, US
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:hypertension   chronic kidney disease   masked hypertension   ambulatory blood pressure monitor
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