文章基本信息

标题：How Do I Manage Hypertension in Patients with Advanced Chronic Kidney Disease Not on Dialysis? Perspectives from Clinical Practice
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作者：Erietta Polychronopoulou ; Gregoire Wuerzner ; Michel Burnier 等
期刊名称：Vascular Health and Risk Management
印刷版ISSN：1176-6344
电子版ISSN：1178-2048
出版年度：2021
卷号：Volume 17
页码：1-11
DOI：10.2147/VHRM.S292522
出版社：Dove Medical Press Ltd
摘要：In the general population, the prevalence of moderate and severe chronic kidney disease (CKD) is usually below 5% but this figure is often higher in specific groups of patients such as those with type 2 diabetes. Patients with advanced CKD (CKD stage 3b and 4) are at high or very high cardiovascular risk, and their risk of progressing towards end-stage kidney disease (CKD stage 5) and the need of renal replacement therapy are elevated. Hypertension is a major cause of poor cardiovascular and renal outcomes in severe CKD. Therefore, an adequate control of blood pressure (BP) is mandatory. However, normalizing BP is often challenging in these patients because the clinical management of hypertension in advanced CKD is not well defined and rarely supported by large randomized controlled trials. In the present review, we discuss the characteristics of hypertension in advanced CKD, excluding dialysis, and its management integrating data from recent clinical studies and a pragmatic approach enriched by a long-standing clinical experience. © 2021 Polychronopoulou et al.
关键词：CKD stage 3b-4;SGLT2 inhibitors;blockers of the renin-angiotensin;calcium antagonists;chronic kidney disease;diuretics;hypertension