2013, Number 3
<< Back Next >>
Rev Fac Med UNAM 2013; 56 (3)
Treatment of hypertension in CKD patient
Méndez DA
Language: Spanish
References: 34
Page: 12-20
PDF size: 264.14 Kb.
ABSTRACT
Improvement in survival involves a greater possibility of developing chronic degenerative diseases among which diabetes mellitus and hypertension stand out. Chronic kidney disease (CKD) is now a pandemic and hypertension is present in virtually all stages of CKD, the uncontrolled hypertension and the need to ingest more drugs to have adequate blood pressure values becomes more evident as disease stage progresses. Renal patients have high blood pressure difficult to control, and combine adrenergic activation, activation of the renin angiotensin aldosterone nervous system, water retention and vascular mechanisms. Current antihypertensive treatment when kidney damage is present focuses on reducing blood pressure, reducing cardiovascular risk and providing renoprotection; angiotensin receptor antagonists have been proven to be the pharmacological therapy of choice regardless of the underlying disease and the degree of proteinuria, the combination with ACEI does not result in a greater benefit but do produce serious adverse effects such as hyperkalemia, and even potentially lethal damage, including sudden death syndrome. Treatment of hypertension in CKD must go beyond just reducing blood pressure, considering that cardiovascular risk is greatly increased in these patients and that slowing the progression of kidney damage is imperative.
REFERENCES
Méndez-Durán A, Méndez-Bueno JF, Tapia-Yáñez T, Muñoz- Montes A y Aguilar-Sánchez L. Epidemiología de la insuficiencia renal crónica en México. Diálisis y Trasplante. 2010;31(1):7-11.
Hypertension companion to Brenner & Rector´s The Kidney. Susanne Oparil, Michael A. Weber. Elsevier Saunders. Second edition, 2005. p. 281.
Johnson RJ, Kang D, Feig D, Kivlighn S, Kanellis J, Watanabe S, et al. Is There a Pathogenetic Role for Uric Acid in Hypertension and Cardiovascular and Renal Disease? Hypertension. 2003;41:1183-90.
Brenner y Rector. El Riñón Tratado de Nefrología. Séptima edición 2004. Editorial Elsevier-Saunder. Vol 2. 2109-10.
Filippone EJ, Foy A, Newman E. Goal-directed antihypertensive therapy: Lower may not always be better. Cleveland Clinic Journal of Medicine. 2001;78(2):123-33.
Lewington S. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002;360:1903-13.
Torres PJ, Kaji KJ, Salas PG, Delgadillo SM, Breien AH, Arreola MH. Morbi-mortalidad en diálisis peritoneal continua ambulatoria. Experiencia con el uso de doble bolsa. Estudio multicentrico ISSSTE. Nefrol Mex. 2001;22(4):189-94.
Méndez DA, Fermín PJ. Mortalidad en ingresos a diálisis peritoneal. Estudio comparativo de la modalidad continua ambulatoria y automatizada. Rev Fac Med UNAM. 2009;52(5):199-203.
Goicoechea MÁ. Enfermedad cardiovascular en pacientes con estadios 4 y 5 de enfermedad renal crónica. Pacientes en diálisis crónica. Nefrología. 2004;4(Suppl 6):142-160.
Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic Kidney Disease and the Risks of Death, Cardiovascular Events, and Hospitalization. N Engl J Med. 2004:351:1296-306.
Clinical practice guidelines on hypertension and antihypertensive agents in chronic kidney disease (CKD) The Indian Society of Nephrology. Indian J Nephrol. 2005;15(Suppl 1):S14-S22.
Gorostidi M, Marín R. Tratamiento de la hipertensión arterial en enfermos con insuficiencia renal. Estadios 2 y 3 de la enfermedad renal Crónica. Nefrología. 2004;24(suppl 6):91-100.
Deferrari G, Ravera M, Berruti V, Leoncini G, Deferrari L. Optimizing Therapy in the Diabetic Patient with Renal Disease: Antihypertensive Treatment. J Am Soc Nephrol. 2004;15:S6-S11.
Méndez-Durán A. Inhibidores del sistema renina-angiotensina aldosterona. Diferencias farmacológicas. Rev Med Inst Mex Seguro Soc. 2011;49(1):45-52.
Clinical Practice Guidelines on Hypertension and Antihypertensive Agents in Chronic Kidney Disease. National Kidney Foundation. KDOQI 2004.
McClellan WM, Flanders WD. Risk Factors for Progressive Chronic Kidney Disease. J Am Soc Nephrol. 2003; 14:S65-S70.
Kunz R, Friedrich C, Wolbers M, Mann J. Meta-analysis: Effect of Monotherapy and Combination Therapy with Inhibitors of the Renin–Angiotensin System on Proteinuria in Renal Disease. Ann Intern Med. 2008;148:30-48.
Wenzel René R. Renal Protection in Hypertensive Patients: Selection of Antihypertensive Therapy. Drugs. 2005;65(suppl 2): 29-39.
Rump Lars C. Secondary rise of albuminuria under AT1- receptor blockade- what is the potential role of aldosterone escape? Nephrol Dial Traspl. 2007;22(1):5-8.
Luft Friedrich C. Renin inhibition and atherosclerosis. Nephrol Dial Transplant. 2008;23(8):2474-6.
Parving HH, Persson F, Lewis JB, Lewis EJ, Hollenberg NK; AVOID Study Investigators. Aliskiren conbined with losartan in type 2 diabetes and nephropathy. J Engl J Med. 2008;358(23):2433-46.
Solomon SD, Appelbaum E, Manning WJ, Verma A, Berglund T, Lukashevich V, et al. Effect of the direct renin inhibitor aliskiren, the angiotensin receptor blocker lo- sartan or both on left ventricular mass in patients with hypertension and left ventricular hypertrophy. Circulation. 2009;119(4):530-7.
Giverhaug T, Falck A, Eriksen BO. Effectiveness of antihypertensive treatment in chronic renal failure: to what extent and with which drugs do patients treated by nephrologists achieve the recommended blood pressure? Journal of Human Hypertension. 2004;18:649-54.
Bakris George L. Dual RAAS blockade is diserable in kidney disease. Kidney International. 2010;78:546-9.
Messerli Franz H. The sudden demise of dual rennin angiotensin system blockade or the soft science of the subrrogate end point. Journal of American College Cardiology. 2009;53(6):468-70.
Telmisartan, Ramipril, or Both in Patients at High Risk for Vascular Events. The ONTARGET Investigators. N Engl J Med. 2008;358:1547-59.
Brenner BM, Cooper ME, Zeeuew D, Keane WF, Mitch WE, Parving HH, et al. For the RENAAL Study Investigators. Effects of losartan on renal and cardiovascular outcomes in patients with type 2 diabetes and nephropathy. N Engl J Med. 2001;345:861-9.
Ibsen H, Olsen MH, Wachtell K, Borch-Johnsen K, Lindholm LH, Mogensen CE, et al. Reduction in Albuminuria Translates to Reduction in Cardiovascular Events in Hypertensive Patients Losartan Intervention for Endpoint Reduction in Hypertension Study. Hypertension. 2005;45:198-202.
Haller H, Ito S, Izzo JL, Januszewicz A, Katayama S, Menne J, et al. For the ROADMAP Trial Investigators. Olmesartan for the Delay or Prevention of Microalbuminuria in Type 2 Diabetes. N Engl J Med. 2011;364:907-17.
Mann JF, Schmieder RL, Dyal L, McQueen MJ, Schumacher H, Pogue J, et al. For the TRANSCEND (Telmisartan Randomised Assessment Study in ACE Intolerant Subjects with Cardiovascular Disease) Investigators. Effect of Telmisartan on Renal Outcomes A Randomized Trial. Ann Intern Med. 2009;151:1-10.
Bilous R, Chaturvedi N, Sjølie A, Fuller J, Klein R, Orchard T, et al. Effect of Candesartan on Microalbuminuria and Albumin Excretion Rate in Diabetes Three Randomized Trials. Ann Intern Med. 2009;151:11-20.
Enyu I, Sadayoshi I, Masakazu H, Juliana CN, Hirofumi M. For the ORIENT Investigators. Olmesartan Reducing Incidence of Endstage Renal Disease in Diabetic Nephropathy Trial (ORIENT): Rationale and Study Design. Hypertens Res. 2006;29:703-70.
Manciaa G, Laurent S, Agabiti-Roseic E, Ambrosioni E, Burniere M, Caulfieldf MJ, et al. Reappraisal of European guidelines on hypertension management: a European Society of Hypertension Task Force document. Journal of Hypertension. 2009;27(11):2121-58.
Miyata T, Ypersele de Strihou CV. Renoprotection of angiotensin receptor blockers: beyond blood pressure lowering. Nephrol Dial Transplant. 2006;21:846-9.