Hypertension management in patients with chronic kidney disease

2008 ◽  
Vol 10 (5) ◽  
pp. 367-373 ◽  
Author(s):  
Biff F. Palmer
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Hypertension Management

Hypertension management in chronic kidney disease: translating guidelines into daily practice

2011 ◽  
Vol 24 (6) ◽  
pp. 733-741 ◽  
Author(s):  
Luca De Nicola ◽  
Silvio Borrelli ◽  
Paolo Chiodini ◽  
Pasquale Zamboli ◽  
Carmela Iodice ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Daily Practice ◽  
Hypertension Management

scholarly journals Novel strategies of hypertension management in chronic kidney disease

2019 ◽  
Author(s):  
Jacek Rysz ◽  
Maciej Banach ◽  
Beata Franczyk ◽  
Anna Gluba-Brzozka
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Hypertension Management

Hypertension management in chronic kidney disease

2020 ◽  
Author(s):  
Francesca Mallamaci ◽  
Anna Pisano ◽  
Giovanni Tripepi
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Hypertension Management

Hypertension management in patients with chronic kidney disease

2019 ◽  
Vol 44 (12) ◽  
pp. 34-40
Author(s):  
Toddra S. Liddell ◽  
Robin Bassett ◽  
Denise K. Link
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Hypertension Management

Abstract P265: Blood Pressure Control is Better and Less Expensive in Chronic Kidney Disease When Associated Metabolic Acidosis is Treated with Fruits and Vegetables Rather Than Sodium Bicarbonate

Hypertension ◽  
2016 ◽  
Vol 68 (suppl_1) ◽  
Author(s):  
Nimrit Goraya ◽  
Jan Simoni ◽  
Jessica Pruszynski ◽  
Pin Xiang ◽  
Donald Wesson
Keyword(s):  
Blood Pressure ◽  
Chronic Kidney Disease ◽  
Metabolic Acidosis ◽  
Kidney Disease ◽  
Sodium Bicarbonate ◽  
Usual Care ◽  
Blood Pressure Control ◽  
Fruits And Vegetables ◽  
Pressure Control ◽  
Hypertension Management

Background: Both sodium bicarbonate (NaHCO 3 ) and base-producing fruits and vegetables (F+V) improve metabolic acidosis in chronic kidney disease (CKD) and appear to provide similar levels of kidney protection. Because F+V themselves reduce blood pressure, we examined if treatment of metabolic acidosis in CKD with F+V was associated with improved blood pressure control, using fewer anti-hypertensive drugs, and thereby with lower cost of hypertension management. Methods: We randomized 108 subjects with CKD stage 3 eGFR (30-59 ml/min) and metabolic acidosis as follows: F+V (n=36) added to reduce dietary potential renal acid load (PRAL) 50%, oral NaHCO 3 (HCO 3 , n=36) to reduce PRAL 50%, or no alkali (Usual Care, n=36). All were treated toward systolic blood pressure (SBP) <130 mmHg with regimens including ACE inhibition and followed 5 years. Results: Entry SBP and initial doses of 5 formulary anti-hypertensive drugs most commonly used for blood pressure control in CKD were not different among the 3 groups. At 5 years, SBP was lower in F+V (125±5 mm Hg) than both HCO 3 and Usual Care (135±5 and 134±5 mm Hg, respectively, p<0.01 vs. F+V for each). Daily doses for the following drugs at year 5 were lower in F+V than HCO 3 and Usual Care: Enalapril (8.3±2.4 vs. 11.1±3.6 and 11.7±4.8, mg/day, respectively, p<0.01), Diltiazem (1.7±7.0 vs. 145.8±36.0 and 153.3±35.7, mg/day, p<0.01), Clonidine (0.14±0.20 vs. 0.65±0.15 and 0.63±0.16, mg/day, p<0.01), Atenolol (0 vs. 6.25±15.1 and 6.25±15.1 mg/day, p<0.02) but there was no difference among groups in the year 5 dose of hydrochlorthiazide (16.1±9.9 vs. 21.9±16.2 and 21.5±16.3 mg/day, p=0.27). Five-year drug cost of hypertension management was less in F+V ($79,760) than both HCO 3 ($155,372) and Usual Care ($152,305). Conclusions: Treating metabolic acidosis in CKD patients with F+V but not NaHCO 3 was associated with lower SBP, use of fewer and lower doses of anti-hypertensive drugs, and lower group cost of hypertension management. The data support that clinicians consider these adjunctive benefits of F+V on hypertension management when recommending treatment strategies for metabolic acidosis in CKD.

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