Abstract
Hypertension is present in ∼90% of patients in late-stage CKD. There are scarce data focusing on the transition period between CKD Stages 4 and 5 (end-stage kidney disease) as it relates to hypertension evaluation and management. Here, we propose that a combination of the principles used in the management of patients with CKD Stages 4 and 5 be applied to patients in this transition. These include the use of out-of-office blood pressure (BP) monitoring (eg, home BP), avoidance of excessively tight BP goals, emphasis of sodium restriction, preferential use of blockers of the renin-angiotensin system and diuretics, and consideration of the use of beta blockers.
Keywords:
CKD; Hypertension.
Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.
MeSH terms
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Adrenergic beta-Antagonists / therapeutic use
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Angiotensin Receptor Antagonists / therapeutic use
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Angiotensin-Converting Enzyme Inhibitors / therapeutic use
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Antihypertensive Agents / therapeutic use*
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Blood Pressure
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Blood Pressure Monitoring, Ambulatory
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Calcium Channel Blockers / therapeutic use
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Diet, Sodium-Restricted
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Disease Progression
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Diuretics / therapeutic use
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Hypertension / complications
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Hypertension / diet therapy
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Hypertension / drug therapy*
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Kidney Failure, Chronic / complications
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Kidney Failure, Chronic / physiopathology
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Mineralocorticoid Receptor Antagonists / therapeutic use
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Renal Insufficiency, Chronic / complications
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Renal Insufficiency, Chronic / physiopathology*
Substances
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Adrenergic beta-Antagonists
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Angiotensin Receptor Antagonists
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Angiotensin-Converting Enzyme Inhibitors
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Antihypertensive Agents
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Calcium Channel Blockers
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Diuretics
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Mineralocorticoid Receptor Antagonists