Cargando…
Hypertension in Chronic Glomerulonephritis
Chronic glomerulonephritis (GN), which includes focal segmental glomerulosclerosis and proliferative forms of GN such as IgA nephropathy, increases the risk of hypertension. Hypertension in chronic GN is primarily volume dependent, and this increase in blood volume is not related to the deterioratio...
Autor principal: | |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Korean Society of Electrolyte Metabolism
2015
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4737660/ https://www.ncbi.nlm.nih.gov/pubmed/26848302 http://dx.doi.org/10.5049/EBP.2015.13.2.41 |
_version_ | 1782413502587076608 |
---|---|
author | Ihm, Chun-Gyoo |
author_facet | Ihm, Chun-Gyoo |
author_sort | Ihm, Chun-Gyoo |
collection | PubMed |
description | Chronic glomerulonephritis (GN), which includes focal segmental glomerulosclerosis and proliferative forms of GN such as IgA nephropathy, increases the risk of hypertension. Hypertension in chronic GN is primarily volume dependent, and this increase in blood volume is not related to the deterioration of renal function. Patients with chronic GN become salt sensitive as renal damage including arteriolosclerosis progresses and the consequent renal ischemia causes the stimulation of the intrarenal renin-angiotensin-aldosterone system(RAAS). Overactivity of the sympathetic nervous system also contributes to hypertension in chronic GN. According to the KDIGO guideline, the available evidence indicates that the target BP should be ≤140mmHg systolic and ≤90mmHg diastolic in chronic kidney disease patients without albuminuria. In most patients with an albumin excretion rate of ≥30mg/24 h (i.e., those with both micro-and macroalbuminuria), a lower target of ≤130mmHg systolic and ≤80mmHg diastolic is suggested. The use of agents that block the RAAS system is recommended or suggested in all patients with an albumin excretion rate of ≥30mg/ 24 h. The combination of a RAAS blockade with a calcium channel blocker and a diuretic may be effective in attaining the target BP, and in reducing the amount of urinary protein excretion in patients with chronic GN. |
format | Online Article Text |
id | pubmed-4737660 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | The Korean Society of Electrolyte Metabolism |
record_format | MEDLINE/PubMed |
spelling | pubmed-47376602016-02-04 Hypertension in Chronic Glomerulonephritis Ihm, Chun-Gyoo Electrolyte Blood Press Review Chronic glomerulonephritis (GN), which includes focal segmental glomerulosclerosis and proliferative forms of GN such as IgA nephropathy, increases the risk of hypertension. Hypertension in chronic GN is primarily volume dependent, and this increase in blood volume is not related to the deterioration of renal function. Patients with chronic GN become salt sensitive as renal damage including arteriolosclerosis progresses and the consequent renal ischemia causes the stimulation of the intrarenal renin-angiotensin-aldosterone system(RAAS). Overactivity of the sympathetic nervous system also contributes to hypertension in chronic GN. According to the KDIGO guideline, the available evidence indicates that the target BP should be ≤140mmHg systolic and ≤90mmHg diastolic in chronic kidney disease patients without albuminuria. In most patients with an albumin excretion rate of ≥30mg/24 h (i.e., those with both micro-and macroalbuminuria), a lower target of ≤130mmHg systolic and ≤80mmHg diastolic is suggested. The use of agents that block the RAAS system is recommended or suggested in all patients with an albumin excretion rate of ≥30mg/ 24 h. The combination of a RAAS blockade with a calcium channel blocker and a diuretic may be effective in attaining the target BP, and in reducing the amount of urinary protein excretion in patients with chronic GN. The Korean Society of Electrolyte Metabolism 2015-12 2015-12-30 /pmc/articles/PMC4737660/ /pubmed/26848302 http://dx.doi.org/10.5049/EBP.2015.13.2.41 Text en Copyright © 2015 The Korean Society of Electrolyte Metabolism http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Review Ihm, Chun-Gyoo Hypertension in Chronic Glomerulonephritis |
title | Hypertension in Chronic Glomerulonephritis |
title_full | Hypertension in Chronic Glomerulonephritis |
title_fullStr | Hypertension in Chronic Glomerulonephritis |
title_full_unstemmed | Hypertension in Chronic Glomerulonephritis |
title_short | Hypertension in Chronic Glomerulonephritis |
title_sort | hypertension in chronic glomerulonephritis |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4737660/ https://www.ncbi.nlm.nih.gov/pubmed/26848302 http://dx.doi.org/10.5049/EBP.2015.13.2.41 |
work_keys_str_mv | AT ihmchungyoo hypertensioninchronicglomerulonephritis |