| Title | Should diuretics always be included as initial antihypertensive management in early-stage CKD? | | Author(s) | Segura J, Ruilope LM | | Institution | Hypertension Unit, Nephrology Department, Hospital 12 de Octubre, Madrid, Spain. | | Source | Curr Opin Nephrol Hypertens 2009 Jun 24. | | Abstract | PURPOSE OF REVIEW: This review focuses on the need for combined antihypertensive therapy drugs in patients with chronic kidney disease and the relevance of diuretics.
RECENT FINDINGS: Chronic kidney disease is a high-risk situation characterized by the presence of volume overload-related hypertension, micro/macroalbuminuria and other traditional and nontraditional risk factors. To achieve the blood pressure goal in these patients, combined antihypertensive therapy (including diuretics) is usually required.
SUMMARY: Extracellular volume expansion is an important, if not the most important, contributing factor to hypertension seen in chronic kidney disease. Protection against progression of renal dysfunction has two main requirements: strict blood pressure control and lowering proteinuria to values as near to normal as possible. Diuretics have been a useful tool to manage volume overload and to achieve strict blood pressure control in patients with chronic kidney disease. Albeit other blood pressure-lowering agents offer additional favorable effects independently of blood pressure changes, diuretics will continue to be used in these patients. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 19561495 |
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