title: The kidney and hypertension: causes and treatment.
abstract: Chronic kidney disease is both a cause and a consequence of hypertension. Extracellular volume expansion is an important, if not the most important, contributing factor to hypertension seen in chronic kidney disease. Beyond volume expansion, chronic kidney disease-related hypertension is without truly defining characteristics. Consequently, the sequencing of antihypertensive medications for the patient with chronic kidney disease and hypertension becomes arbitrary. Prescription practice in such patients should be mindful of the need for multiple drug classes with at least one of them being a diuretic. Blood pressure goals in the patient with chronic kidney disease and hypertension are set at lower levels than those for patients with essential hypertension alone. It remains to be determined to what level blood pressure should be lowered in the patient with chronic kidney disease, however.
authors.affiliation: Section of Clinical Pharmacology and Hypertension, Division of Nephrology, Virginia Commonwealth University Health System, Richmond, VA 23298-0160, USA. dsica@mcvh-vcu.edu
authors.forename: Domenic A
authors.initials: DA
authors.lastname: Sica
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use*; D015897:Comorbidity; D006801:Humans; D006978:Hypertension, Renovascular / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D007668:Kidney / Q000503:physiopathology*; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000503:physiopathology; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
chemical_list: D000959:Antihypertensive Agents