Chronic kidney disease and albuminuria in arterial hypertension.
Chronic kidney disease is a major public health problem worldwide: it is estimated that in the general population, 1 person in 10 has some degree of renal damage. Adequate blood pressure control represents the mainstay of treatment, to delay deterioration of renal function and prevent cardiovascular complications. Current evidence supports a target blood pressure value of 130/80 mm Hg or less (ie, <125/75 mm Hg) when proteinuria exceeds 1 g/L. Angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers represent the treatment of choice, especially in the presence of proteinuria. More complete blockade of the renin-angiotensin-aldosterone system (RAAS) has been advocated, using a combination of multiple RAAS blocker drugs or supramaximal doses to maximize renal protection. Achieving recommended blood pressure target values usually requires the use of multiple antihypertensive drugs, including diuretics and calcium channel blockers.
Leoncini
Giovanna
G
Department of Cardionephrology and Department of Internal Medicine, University of Genoa, Azienda Ospedaliera Universitaria San Martino, Viale Benedetto XV, 6-16132, Genoa, Italy.
Viazzi
Francesca
F
Pontremoli
Roberto
R
D000419:Albuminuria / Q000209:etiology / Q000378:metabolism / Q000517:prevention & control; D057911:Angiotensin Receptor Antagonists / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics; D018660:Blood Pressure Monitoring, Ambulatory / Q000592:standards; D002121:Calcium Channel Blockers / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics; D002986:Clinical Trials as Topic; D042241:Early Diagnosis; D006331:Heart Diseases / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications* / Q000188:drug therapy* / Q000503:physiopathology / Q000652:urine*; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology / Q000517:prevention & control; D007677:Kidney Function Tests / Q000592:standards; D000451:Mineralocorticoid Receptor Antagonists / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics; D012084:Renin-Angiotensin System / Q000187:drug effects / Q000502:physiology; D016896:Treatment Outcome; D000092502:Renin Inhibitors
D057911:Angiotensin Receptor Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D000451:Mineralocorticoid Receptor Antagonists; D000092502:Renin Inhibitors