Core Concepts in Hypertension in Kidney Disease by Ajay K. Singh, Rajiv Agarwal

By Ajay K. Singh, Rajiv Agarwal

This consultant presents a entire assessment of the total spectrum of high blood pressure in power kidney ailment (CKD).  Targeted in the direction of the busy practitioner, the focal point of this quantity is on a variety of cures and the way to decrease blood strain via way of life adjustments.  Specialist sufferer populations and high blood pressure and factors of high blood pressure also are coated intimately.  Clinically-focused and authoritative, this source deals a rationalized method of diagnosing and treating high blood pressure in CKD.

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2012;7(11):1770–6. 46. Minutolo R, Agarwal R, Borrelli S, Chiodini P, Bellizzi V, Nappi F, et al. Prognostic role of ambulatory blood pressure measurement in patients with nondialysis chronic kidney disease. Arch Intern Med. 2011;171(12):1090–8. 47. Agarwal R, Peixoto AJ, Santos SF, Zoccali C. Out-of-office blood pressure monitoring in chronic kidney disease. Blood Press Monit. 2009;14(1):2–11. 48. Kikuya M, Ohkubo T, Asayama K, Metoki H, Obara T, Saito S, et al. Ambulatory blood pressure and 10-year risk of cardiovascular and noncardiovascular mortality: the Ohasama study.

In any event, by virtue of its potent vasoconstrictor effects on the systemic and renal vasculature via the AT1 receptor, Ang II contributes to the maintenance of BP during states of circulatory depression (hypotension) and/or volume depletion. The renal vasoconstrictive effects additionally potentiate the stimulatory effects of Ang II on Na reabsorption by most nephron segments leading to Na and volume conservation. The sodium conservation is further enhanced through the stimulation of aldosterone biosynthesis by Ang II (vide infra).

Salles GF, Cardoso CR, Muxfeldt ES. Prognostic influence of office and ambulatory blood pressures in resistant hypertension. Arch Intern Med. 2008;168(21):2340–6. 29. Kikuya M, Hansen TW, Thijs L, Bjorklund-Bodegard K, Kuznetsova T, Ohkubo T, et al. Diagnostic thresholds for ambulatory blood pressure monitoring based on 10-year cardiovascular risk. Circulation. 2007;115(16):2145–52. 30. Fagard RH, Thijs L, Staessen JA, Clement DL, De Buyzere ML, De Bacquer DA. Night-day blood pressure ratio and dipping pattern as predictors of death and cardiovascular events in hypertension.

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