Importance of blood pressure control in chronic kidney disease

J Am Soc Nephrol. 2006 Apr;17(4 Suppl 2):S98-103. doi: 10.1681/ASN.2005121319.

Abstract

Arterial hypertension together with proteinuria is one of the most important factors associated with the progression of both diabetic and nondiabetic chronic kidney disease. In this review, the role of hypertension and proteinuria in renal disease progression, the BP target that should be achieved to slow the progression of renal damage, and the influence of baseline and current proteinuria on the renoprotective effects of antihypertensive therapy are discussed thoroughly. The interaction between the renoprotective effects of specific antihypertensive agents--mostly angiotensin-converting enzyme inhibitors and angiotensin receptor blockers--and the level of achieved BP also are evaluated. The body of evidence provided by several studies emphasizes the importance of both lowering BP and inhibiting the renin-angiotensin system as specific goals for renal and cardiovascular protection in chronic kidney disease.

Publication types

  • Review

MeSH terms

  • Angiotensin-Converting Enzyme Inhibitors / pharmacology
  • Antihypertensive Agents / pharmacology
  • Blood Pressure*
  • Disease Progression
  • Humans
  • Hypertension / complications*
  • Hypertension / etiology
  • Kidney / drug effects
  • Kidney Failure, Chronic / complications*
  • Kidney Failure, Chronic / pathology
  • Proteinuria / diagnosis
  • Renin-Angiotensin System
  • Treatment Outcome

Substances

  • Angiotensin-Converting Enzyme Inhibitors
  • Antihypertensive Agents