Novel strategies of hypertension management in chronic kidney disease

Abstract

Hypertension is the most frequent comorbidity affecting patients with chronic kidney disease. It causes functional and structural changes in the kidney. According to the results of the Chronic Renal Insufficiency Cohort (CRIC) study, 67% to 92% of patients with chronic kidney disease (CKD) suffer from hypertension, with increasing prevalence as kidney function declines. Hypertension is a complex polygenic disorder the occurrence of which depends on the interaction of the effects of many genes or gene combinations as well environmental factors. This review presents novel recommendations concerning hypertension treatment of chronic kidney disease patients, including ACE inhibitor (in order to slow down kidney disease progression), angiotensin II receptor blocker therapy, bumetanide, furosemide, calcium antagonist, etc. Moreover, non-pharmacological interventions aiming at reducing blood pressure, such as diet and life-style change and renal denervation, are described herein. Finally, we presented novel, emerging strategies including neprilysin and sacubitril/valsartan (LCZ696).