Abstract

AN OVERVIEW OF HYPERTENSION IN CHRONIC KIDNEY DISEASE

Anjana Sri Satya Veeravalli*, Kuchibhatla Lakshmi Vardhani, Amrutha Jampana, Beg Karishma, Natta Prathibha and Kantamaneni Padmalatha

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Abstract

Chronic kidney disease (CKD) and hypertension are closely related pathophysiological conditions; as a result, hypertension can deteriorate kidney function, and a progressive reduction in renal function can in turn, worsen blood pressure regulation. The prevalence of hypertensive end-stage renal disease keeps rising yearly. Controlling systolic and diastolic hypertension is crucial to lowering this incidence. The prevalence ranges from 60-90% depending on the stage of CKD and its causes. The mechanism of hypertension in CKD includes volume overload, sympathetic dysfunction, and alteration in hormonal systems that regulate blood pressure. This review presents information concerning the pathophysiological mechanism of hypertensive renal disease, the role of salt restriction, and management issues in HTN in patients with CKD including the timing of anti-hypertensive medication dosing, and blood pressure targets. Addressing this salt sensitivity is critical for the management of HTN in CKD whenever possible ACE inhibitors should be part of the treatment. Since these drugs are reno-protective beyond their antihypertensive effect in certain strategies for delaying kidney progression. In order to achieve the target blood pressure levels advised by worldwide recommendations, numerous levels of care, including a number of pharmacological and behavioural changes, are frequently necessary. The residual cardiovascular risk is substantial even when blood pressure is properly controlled. With the addition of fresh information from clinical research, we will examine both the traditional and novel features of managing hypertension in CKD in the current review.

Keywords: Hypertension, chronic kidney disease, ambulatory blood pressure monitoring, achieving blood pressure, salt restriction.