Hypertension Management in Chronic Kidney Disease

Abstract

Introduction: Hypertension is both a cause and consequence of CKD, accelerating progression to ESRD. Methods: Meta-analysis of 25 RCTs evaluating blood pressure targets and antihypertensive classes in non-dialysis CKD patients. Results: Lower systolic target (<120 mmHg vs. <140 mmHg) reduced mortality by 20% but increased adverse events (hypotension, acute kidney injury). ACE inhibitors/ARBs reduced proteinuria by 35% more than other agents. Discussion: Strict BP control is beneficial in proteinuric CKD but requires monitoring for hyperkalemia and eGFR dip. Conclusion: Individualized BP targets based on proteinuria and age are recommended.