Hypertension and kidney disease: A deadly connection |
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Authors: | Yousri M Barri MD |
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Institution: | (1) Division of Nephrology and Transplantation, Baylor University Medical Center, 3500 Gaston Avenue, 75246 Dallas, TX, USA |
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Abstract: | Kidney disease may be the cause or a consequence of hypertension. Hypertension affects 25% of the adult population in the
United States. Similarly, chronic kidney disease (CKD) and end-stage renal disease (ESRD) have been steadily increasing in
incidence because of the increasing age of the US population and rise in the incidence of risk factors, including hypertension.
Substantial evidence supports the notion that elevated blood pressure is the most significant risk factor for the development
of CKD. Microalbuminuria has been shown to be the early marker of hypertensive renal disease. Furthermore, therapy to reduce
microalbuminuria was associated with delay in the progression of renal disease. Black Americans are at higher risk for developing
hypertensive nephrosclerosis than whites. Hypertension is a major risk factor for cardiovascular events in patients with CKD
and ESRD and those who have undergone renal transplantation. Studies have documented that elevated serum creatinine and CKD
are risk factors for a cardiovascular event. Tight blood pressure control has been shown to reduce microalbuminuria and proteinuria
and to delay progression of renal disease. Tailoring the choice of antihypertensive medication to the clinical setting to
achieve a blood pressure goal is critical in reducing complications from this deadly connection. |
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