Pathologic basis and treatment considerations in chronic kidney disease-related hypertension.
Chronic kidney disease (CKD) is both a cause and an effect of hypertension and is multifactorial in its origin. Beyond volume expansion, CKD-related hypertension is without defining characteristics of any consistency. Consequently, the order in which antihypertensive medications are given to the CKD patient with hypertension is arbitrary, although prescription practice is for the most part mindful of the need for multiple drug classes with at least one of them being a diuretic. It is not without reason that blood pressure goals in the hypertensive CKD patient are set at lower levels than those for patients with essential hypertension, but it remains to be determined how much the blood pressure should be decreased in the CKD patient.
Sica
Domenic
D
Section of Clinical Pharmacology and Hypertension, Division of Nephrology, Virginia Commonwealth University Health System, Richmond, VA 23298-0160, USA. dsica@hsc.vcu.edu
Carl
Dan
D
D000959:Antihypertensive Agents / Q000627:therapeutic use*; D002908:Chronic Disease; D004232:Diuretics / Q000627:therapeutic use*; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy*; D007674:Kidney Diseases / Q000188:drug therapy* / Q000209:etiology*
D000959:Antihypertensive Agents; D004232:Diuretics