Treatment of hypertension in chronic renal insufficiency

Abstract

Hypertension is the most common complication of chronic renal insufficiency (CRI) and it accelerates the rate of progression of most forms of CRI. Several large clinical trials have clearly demonstrated the efficacy of antihypertensive treatment for prevention of progression of renal failure. Angiotensin-converting enzyme (ACE) inhibitors may have therapeutic advantages. However, large scale trials include a variety of chronic renal diseases, and the origins of renal diseases are quite diverse. Moreover, the differences in sex, age, race have not been considered. Based on these trials, it was concluded that blood pressure control is the most effective means for the prevention of deterioration of renal dysfunction. Consistent with this view, our recent preliminary data provide evidence that aggressive blood pressure control using self-reported blood pressure values measured by a home blood pressure device is promising to arrest the progression of renal failure in Japanese patients with CRI.