Med. Pro Praxi 2009; 6(2): 73-76

Hypertension in chronic renal insufficiency

prof. MUDr. Václav MONHART CSc^1,2

¹ III. interní oddělení, Ústřední vojenská nemocnice Praha

² Interní klinika 1. LF UK a ÚVN, KlinLab s. r. o., Praha

Hypertension accompanying renal disease is among the most common secondary hypertensions. Chronic renal diseases affect approximately

10 % of the population. Four percent of adult persons are expected to have concurrent chronic renal insufficiency (CRI) of varied

severity and hypertension. The pathogenesis of hypertension in CRI mostly involves impaired regulation of extracellular fluid volume

and imbalance between vasoconstrictive and vasodilatory agents. The goals of treatment for hypertension in CRI are to attain a target

blood pressure of less than 130/80 mm Hg, slow down the progression of chronic renal disease, interfere with pre-existent hypertensionrelated

complications, and manage other risk factors of cardiovascular disease. Attainment of effective hypertension control requires

a combination of several antihypertensives. The mainstay of pharmacological treatment of hypertension in CRI is blockade of the reninangiotensin

system with angiotensin-converting enzyme inhibitors or angiotensin II antagonists – AT1 receptor blockers.

Keywords: arterial hypertension, chronic renal insufficiency, antihypertensives.

Published: May 1, 2009  Show citation