How Do I Manage Hypertension in Patients with Advanced Chronic Kidney Disease Not on Dialysis? Perspectives from Clinical Practice.

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State: Public
Version: Final published version
License: CC BY-NC 4.0
Serval ID
serval:BIB_688099EFB06D
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
How Do I Manage Hypertension in Patients with Advanced Chronic Kidney Disease Not on Dialysis? Perspectives from Clinical Practice.
Journal
Vascular health and risk management
Author(s)
Polychronopoulou E., Wuerzner G., Burnier M.
ISSN
1178-2048 (Electronic)
ISSN-L
1176-6344
Publication state
Published
Issued date
2021
Peer-reviewed
Oui
Volume
17
Pages
1-11
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: epublish
Abstract
In the general population, the prevalence of moderate and severe chronic kidney disease (CKD) is usually below 5% but this figure is often higher in specific groups of patients such as those with type 2 diabetes. Patients with advanced CKD (CKD stage 3b and 4) are at high or very high cardiovascular risk, and their risk of progressing towards end-stage kidney disease (CKD stage 5) and the need of renal replacement therapy are elevated. Hypertension is a major cause of poor cardiovascular and renal outcomes in severe CKD. Therefore, an adequate control of blood pressure (BP) is mandatory. However, normalizing BP is often challenging in these patients because the clinical management of hypertension in advanced CKD is not well defined and rarely supported by large randomized controlled trials. In the present review, we discuss the characteristics of hypertension in advanced CKD, excluding dialysis, and its management integrating data from recent clinical studies and a pragmatic approach enriched by a long-standing clinical experience.
Keywords
Antihypertensive Agents/adverse effects, Antihypertensive Agents/therapeutic use, Blood Pressure/drug effects, Diet, Healthy, Diet, Sodium-Restricted, Glomerular Filtration Rate/drug effects, Humans, Hypertension/epidemiology, Hypertension/physiopathology, Hypertension/therapy, Kidney/drug effects, Kidney/physiopathology, Kidney Failure, Chronic/epidemiology, Kidney Failure, Chronic/physiopathology, Kidney Failure, Chronic/prevention & control, Renal Insufficiency, Chronic/epidemiology, Renal Insufficiency, Chronic/physiopathology, Renal Insufficiency, Chronic/therapy, Treatment Outcome, CKD stage 3b-4, SGLT2 inhibitors, blockers of the renin-angiotensin, calcium antagonists, chronic kidney disease, diuretics, hypertension
Pubmed
Web of science
Open Access
Yes
Create date
08/02/2021 9:18
Last modification date
16/07/2021 6:10
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