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Treatment of hypertension in chronic renal insufficiency


Authors: V. Monhart
Authors‘ workplace: nefrologické oddělení, Interní klinika 1. LF UK a ÚVN, Praha
Published in: Kardiol Rev Int Med 2006, 8(4): 202-207
Category: Editorial

Overview

The aim of treatment of patients with arterial hypertension and chronic renal insufficiency is to achieve of target blood pressure values, reduction of cardiovascular morbidity/mortality and delaying of renal impairment progression. The essential therapy is combination of two or more antihypertensive drugs, which is completed by non-pharmacologic measures. All classes of antihypertensive drugs are effective. Their choice and dosage depends on severity of renal insufficiency and route their elimination. Angiotensin-converting enzyme inhibitors, angiotensin II-receptor blockers and non-dihydropyridine calcium channel blockers, which in addition to antihypertensive have also antiproteinuric effect, are first choice of drugs in hypertensive patients with chronic renal insufficiency. The timely beginning of regular monitoring of renal function and potassium serum level is essential precondition of safe therapy.

Keywords:
arterial hypertension - renal insufficiency - angiotensin-converting enzyme inhibitors - angiotensin II-receptor blockers - calcium channel blockers


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