Importance of blood pressure control in chronic kidney disease.
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.
Division of Nephrology, Dialysis and Transplantation, Department of Internal Medicine, University of Genoa, 16123 Genoa, Italy.
Maura
M
Ravera
Michela
M
Re
Luca
L
Deferrari
Simone
S
Vettoretti
Giacomo
G
Deferrari
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology; D000959:Antihypertensive Agents / Q000494:pharmacology; D001794:Blood Pressure; D018450:Disease Progression; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000209:etiology; D007668:Kidney / Q000187:drug effects; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000473:pathology; D011507:Proteinuria / Q000175:diagnosis; D012084:Renin-Angiotensin System; D016896:Treatment Outcome
D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents