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Risk Stratification of Resistant Hypertension in Chronic Kidney Disease

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Resistant Hypertension in Chronic Kidney Disease

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Abstract

Resistant hypertension (RHTN) is an increasingly common clinical problem which is recognized more than the past. RTHN is defined as uncontrolled blood pressure on optimal doses of three or more antihypertensive agents, ideally one being a diuretic. It causes cardiovascular and renal complications. RHTN may be a part of chronic kidney disease (CKD). RHTN diagnosis should be made early and treatment should be effective. Because it is a significant reason for morbidity and mortality in CKD patients, a clinician should do a good risk stratification for an effective treatment. Pseudoresistant (PR) hypertension has crucial importance in risk stratification of RHTN patients. High dietary sodium consumption, poor lifestyle and dietary approaches, and inadequate use of drugs cause pseudoresistance. Hence, the treatment of PR hypertension is effective and easier than the true resistance (TR).

In the management of RHTN, first of all, the differential diagnosis should be made in between the TR and pseudoresistance. Ambulatory blood pressure monitoring is very important in this context. Comorbid conditions such as diabetes mellitus, smoking, obesity, obstructive sleep apnea, and renal artery stenosis can be considered as additional risk factors. Every successful TR treatment approach to be made towards risk factors shall reduce morbidity and mortality significantly. The aforementioned approach guided treatment shall improve the outcomes of this specific group of patients.

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Author information

Authors and Affiliations

  1. Department of Internal Medicine, Nephrology, Istanbul Florence Nightingale Hospital, Istanbul, Turkey

    Bulent Yardimci

  2. Nephrology Clinic, Haseki Training and Research Hospital, Istanbul, Turkey

    Savas Ozturk

Authors
  1. Bulent Yardimci
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  2. Savas Ozturk
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Correspondence to Savas Ozturk .

Editor information

Editors and Affiliations

  1. Grigore T. Popa University of Medicine, IaÅŸi, Romania

    Adrian Covic

  2. Department of Medicine, Division of Nephrology, University School of Medicine, Istanbul, Turkey

    Mehmet Kanbay

  3. Section of Nephrology, University of Illinois at Chicago College of Medicine/Advocate Christ Medical Center, Oak Lawn, Illinois, USA

    Edgar V. Lerma

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Yardimci, B., Ozturk, S. (2017). Risk Stratification of Resistant Hypertension in Chronic Kidney Disease. In: Covic, A., Kanbay, M., Lerma, E. (eds) Resistant Hypertension in Chronic Kidney Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-56827-0_6

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  • DOI: https://doi.org/10.1007/978-3-319-56827-0_6

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-56825-6

  • Online ISBN: 978-3-319-56827-0

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