title: Resistant Hypertension and Chronic Kidney Disease: a Dangerous Liaison.
abstract: Treatment-resistant hypertension is an increasingly recognised problem and is markedly over-represented in patients with chronic kidney disease (CKD). Recent evidence has clarified the heightened risk for both adverse renal and cardiovascular outcomes associated with resistant hypertension, even when blood pressure control is attained. The diagnosis of resistant hypertension in CKD is reliant on accurate blood pressure measurement, and out of office measurements are important due to the high prevalence of masked hypertension in these patients. Treatment strategies include careful dietary measures to restrict sodium intake, and a focus on improving adherence to antihypertensive medications. Medication choices should focus on a sensible foundation and then diuretic titration to combat the salt and volume retention inherent in CKD. In this review, we discuss the epidemiology, pathogenesis and consequences of resistant hypertension in CKD, and then review the optimal diagnostic and management strategies.
authors.affiliation: Endocrine Hypertension Research Centre, Greenslopes and Princess Alexandra Hospitals, University of Queensland School of Medicine, Ipswich Road, Woolloongabba, Brisbane, 4102, Australia. m.wolley@uq.edu.au.|Department of Nephrology, Royal Brisbane and Women's Hospital, Brisbane, Australia. m.wolley@uq.edu.au.
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Wolley
authors.affiliation: Endocrine Hypertension Research Centre, Greenslopes and Princess Alexandra Hospitals, University of Queensland School of Medicine, Ipswich Road, Woolloongabba, Brisbane, 4102, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Stowasser
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use; D004232:Diuretics / Q000627:therapeutic use; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology*; D008019:Life Style; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000503:physiopathology*
chemical_list: D000959:Antihypertensive Agents; D004232:Diuretics
keywords: CKD; Chronic kidney disease; Resistant hypertension