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Hypertension Treatment for Patients with Advanced Chronic Kidney Disease

  • Arjun D. Sinha
  • Rajiv AgarwalEmail author
Hypertension (S Taler, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Hypertension

Abstract

Chronic kidney disease is common and frequently complicated with hypertension. As a major modifiable risk factor for cardiovascular disease in this high risk population, treatment of hypertension in chronic kidney disease is of paramount importance. We review the epidemiology and pathogenesis of hypertension in chronic kidney disease and then update the latest study results for treatment including salt restriction, invasive endovascular procedures, and pharmacologic therapy. Recent trials draw into question the efficacy of renal artery stenting or renal denervation for hypertension in chronic kidney disease, as well as renin-angiotensin-aldosterone system blockade as first line therapy of hypertension in end stage renal disease. Positive trial results reemphasize salt restriction and challenge the prevailing prejudice against the use of thiazide-like diuretics in advanced chronic kidney disease. Last, clinical practice guidelines are trending away from recommending tight blood pressure control in chronic kidney disease.

Keywords

Chronic kidney disease End stage renal disease Hemodialysis Hypertension Resistant hypertension 

Notes

Compliance with Ethics Guidelines

Conflict of Interest

Rajiv Agarwal and Arjun Sinha declare that they have no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by the author.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media New York (outside the USA) 2014

Authors and Affiliations

  1. 1.Richard L. Roudebush VA Medical CenterIndianapolisUSA
  2. 2.Division of NephrologyIndiana University School of MedicineIndianapolisUSA

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