G Ital Nefrol. 2017 Mar;34:11-19.
Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia
[Article in Italian] Antonio De Pascalis, Alessandro Balducci
PMID: 28682025
The progression of chronic kidney disease CKD is largely independent of the underlying kidney disorder once renal function has fallen below a critical level. Hypertension is an independent risk factor for disease progression in both adult and pediatric patients with kidney disorders. Optimal blood pressure control (130 /80mm Hg) represents a main goal of conservative therapy in patients with chronic kidney disease CKD but it is rarely achieved in clinical practice. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers are more effective than other drugs in slowing progression of proteinuric CKD. Dietary salt restriction (≤100 mEq/die of NaCl) may be useful to correct the extracellular volume expansion. If this intervention fails, hypertension can be treated by thiazide diuretics in patients with mild CKD, whereas loop diuretics at adequate doses are indicated in patients with more advanced CKD.
Copyright by Società Italiana di Nefrologia SIN, Rome, Italy.
Keywords: CKD; RAS inhibitors; diuretics; hypertension
