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
Sources
1. Levey AS, Beto JA, Coronado BE et al. Controlling the epidemic of cardiovascular disease in chronic renal disease: What do we now ? What do we need to learn ? Where do we go from here ? Am J Kidney Dis 1998; 32: 853-906.
2. Mailloux LU, Levey AS. Hypertension in patients with chronic renal disease. Am J Kidney Dis, 1998; 32 (Suppl 3): 120-141.
3. Martinez-Maldonado M. Role of hypertension in the progression of chronic renal disease. Nephrol Dial Transplant 2001; 16 (Suppl 1): 63-66.
4. European Society of Hypertension – European Society of Cardiology Guidelines Comittee. 2003 European Society of Hypertension-European Society of Cardiology guidelines for the management of arterial hypertension. J Hypertens 2003; 21: 1011-1053. Erratum in: J Hypertens 2003; 21: 2203-2204.
5. Chobanian AV, Bakris GL, Black HR et al. The seventh report of the joint national comittee on prevention, detection, evaluation, and treatment of high blood pressure. The JNC 7. JAMA 2003; 289: 2560-2572.
6. Cífková R, Horký K, Widimský J et al. Doporučení diagnostických a léčebných postupů u arteriální hypertenze – verze 2004. Cor Vasa 2005; 47(Suppl K): 3-16.
7. Verdecchia P, Schillaci G, Borgioni C et al. Cigarette smoking, ambulatory blood pressure and cardiac hypertrophy in essential hypertension. J Hypertens 1995; 13: 1209-1215.
8. He J, Whelton PK, Appel LJ et al. Long-term effects of weight loss and dietary sodium reduction on incidence of hypertension. Hypertension 2000; 35: 544-549.
9. Arakawa K. Antihypertensive mechanism of exercise. J Hypertens 1993; 11: 223-229.
10. Fagrell B, De Faire U, Bondy S et al. The effects of light to moderate drinking on cardiovascular diseases. J Intern Med 1999; 4: 331-340.
11. Cutler JA, Follmann D, Allender PS. Randomized trials of sodium reduction: an overview. Am J Clin Nutr 1997; 65(Suppl): 643 -651.
12. Sacks FM, Svetkey LP, Vollmer WM et al. Effects on blood pressure of reduced dietary podium and the Dietary Approaches to Stop Hypertension (DASH) diet. N Engl J Med 2001; 344: 3-10.
13. Ridao N, Luno J, Garcia de Vinuesa S et al. Prevalence hypertension in renal disease. Nephrol Dial Transplant 2001; 16(Suppl 1): 70-73.
14. Garcia de Vinuese S, Luno J, Goméz-Campdera F et al. Effect of strict blood pressure control on proteinuria in reanal patients treated with different antihypertensive drugs. Nephrol Dial Transplant 2001; 16(Suppl 1): 78-81.
15. Kaplan NM. Kaplan's Clinical hypertension. 9th ed. Philadelphia: Lippincott Williams & Wilkins 2006.
16. Palmer BF. Angiotensin-converting enzyme inhibitors and angiotenzin receptor blockers: what to do if the serum creatinine and/or serum potassium concentration rises. Nephrol Dial Transplant 2003; 18: 1973-1975.
17. Ali A. Using of angiotensin-converting enzyme inhibitors in patients with heart failure and renal insufficiency: how concerned should we be by the rise in serum creatinine? J Am Geriatr Soc 2002; 50: 1297-1300.
18. Palmer BF. Renal dysfunction complicating the treatment of hypertension. N Engl J Med 2002; 347: 1256-1261.
19. Bakris GL, Weir MR. Angiotensin-converting enzyme inhibitor-associated elevations in serum creatinine: is this a cause for concern? Arch Intern Med 2000; 160: 685-693.
20. Mandal AK, Market RJ, Saklayen MG et al. Diuretic potentiate angiotensin converting enzyme inhibitor-induced acute renal failure. Clin Nephrol 1994; 42: 170-174.
21. Wynckel A, Ebikili B, Melin JP et al. Long-term follow-up of acute renal failure caused by angiotensin converting enzyme inhibitors. Am J Hypert 1998; 11: 1080-1086.
22. Ljungman S, Kjekshus J, Swedberg K. Renal function in severe congestive heart failure during treatment with enalapril (The Cooperative North Scandinavian Enalapril Survival Study / CONSENSUS/ trial. Am J Cardiol 1992; 70: 479-487.
23. Toto RD. Renal insufficiency due to angiotensin-converting enzyme inhibitors. Min Electrol Metab 1994; 20: 193-200.
24. Navis G, Faber HJ, de Zeeuw D, de Jong PE. ACE inhibitors and the kidney. A risk-benefit assesment. Drug Safety 1996; 15: 200-211.
25. Reardon LS. Hyperkalemia in outpatients using angiotensin-converting enzyme inhibitors. Arch Intern Med 1998; 158: 26-32.
26. Schultz E, Bech NJ, Pedersen EB et al. A randomised, doule-blind parallel study on the safety and antihypertensive efficacy of losartan compared to captopril in patients with mild to moderate hypertension and impaired renal function. Nephrol Dial Transplant 1999; 14(Suppl 4): 27-28.
27. Klahr S, Morrissey J. Comparative effects of ACE inhibition and angiotensin II receptor blockade in the prevention of renal damage. Kidney Int 2002; 62(Suppl): 23-26.
28. Pitt B, Segal R, Martinez FA et al. Randomised trial of losartan ersus capropril in patients over 65 years with heart failure ( Evaluation of Losartan in the Eldery Study, ELITE). Lancet 1997; 349: 747-752.
29. Johnston CI. The place of diuretics in the treatment hypertension in 1993: can we do better? Clin Exp Hypertens 1993; 15: 1239-1255.
30. Puschett JB. Diuretics in hypertension. In: Singh BN et al (eds). Cardiovascular Pharmacology and Therapeutics. New York : Churchill Livingstone 1994: 885-908.
31. Griiffin KA, Picken MM, Bakris GL et al. Class differences in the effects of calcium channel blockers in the rat remnant kidney model. Kidney Int 1999; 55: 1849-1860.
32. Herlitz H, Harris K, Risler T et al. The effects of an ACE inhibitor and a calcium antagonist on the progession of renal disease: The Nephros Study. Nephrol Dial Transplant 2001; 16: 2158-2165.
33. Hayashi K, Ozawa Y, Fujiwara K et al. Role of actions of calcium antagonists on efferent arterioles – with special references to glomerular hypertension. Am J Nephrol 2003; 23: 229-244.
34. Bakris GL, Weir MR, Secic M et al. Differential effects of calcium antagonist subclasses on markers nephropathy progression. Kidney Int 2004; 65: 1991-2002.
35. Misra M, Reams GP, Bauer JH. Hypertension in patients on renal replacement therapy. In: Oparil S, Weber MA (eds). Hypertension: A companion to Brenner and Rector,s The Kidney. Philadelphia: WB Saunders 2000: 531-539.
Labels
Paediatric cardiology Internal medicine Cardiac surgery CardiologyArticle was published in
Cardiology Review
2006 Issue 4
Most read in this issue
- Pacemaker automatic functions
- Measurement of heart stability
- Treatment of hypertension in chronic renal insufficiency
- New antiarrhythmic drugs in treatment of atrial fibrillation