Clinical considerations and strategies for treating hypertension in CKD patients
Hypertension is both a major cause and consequence of chronic kidney disease (CKD). It is associated with increased risk of cardiac events, stroke and kidney disease progression. The latest National Kidney Foundation Clinical Practice Guidelines recommend a blood pressure goal of <130mmHg systolic and <80mmHg diastolic for all CKD patients, regardless of the level of albuminuria. Several non-pharmacological interventions are recommended to achieve this, including weight loss, salt intake restriction and physical activity. As for pharmacological treatment, a combination of renin-angiotensin system (RAS) blocker (either ACE inhibitor or ARB, in case of ACE inhibitor intolerance) with a calcium channel blocker or a diuretic is recommended as initial therapy in patients with CKD stage 3 or higher. A combination of two RAS blockers is not recommended
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