Renal hypertension--the role of the kidneys in blood pressure regulation and the kidneys as end organ

Abstract

Hypertension affects approximately 25%–30% of the adult population and it is predicted that its prevalence will increase. It is a main risk factor for the development of kidney failure and cardiovascular disease and on the other hand 80 % of patients with chronic kidney disease are hypertensive. The interactions between hypertension and kidney disease are complex and it is important to keep pathophysiology in mind in order to get a better understanding of treating hypertension. Renovascular hypertension or renal hypertension means hypertension in context of renal artery stenosis and kidney disease. Thus, patients with newly diagnosed hypertension should be screened for underlying kidney disease and hypertension should be treated in the sense of optimal “nephroprotective” therapy within the target values (blood pressure<130/80 mmHg and proteinuria<1 g/d). First line antihypertensive drugs for treating patients with kidney disease are ACE-Inhibitors or Angiotensin receptor blockers in combination with diuretics and a low sodium diet.