Document Detail

Hypertension and chronic kidney disease: controversies in pathogenesis and treatment.
MedLine Citation:
PMID:  23538309     Owner:  NLM     Status:  MEDLINE    
The relationship between hypertension and chronic kidney disease (CKD) has long been the subject of controversy. The pathogenetic mechanisms of nephropathy in non-diabetic individuals with hypertension, as well as optimal hypertension treatment targets in populations with nephropathy remain important clinical concerns. This manuscript reviews breakthroughs in molecular genetics that have clarified the complex relationship between hypertension and kidney disease, answering the question of which factor comes first. An overview of the potential roles that hyperuricemia plays in the pathogenesis of hypertension and CKD and current blood pressure treatment guidelines in populations with CKD are discussed. The ongoing National Institutes of Health-sponsored Systolic Blood Pressure Intervention Trial (SPRINT) is underway to help answer these important questions. Enrollment of 9250 hypertensive SPRINT participants will be completed in 2013; important results on ideal blood pressure control targets for reducing nephropathy progression, cardiovascular disease end-points, and preserving cognitive function are expected. As such, many of the controversial aspects of hypertension management will likely be clarified in the near future.
J L Pirkle; B I Freedman
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Minerva urologica e nefrologica = The Italian journal of urology and nephrology     Volume:  65     ISSN:  0393-2249     ISO Abbreviation:  Minerva Urol Nefrol     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-03-29     Completed Date:  2013-07-17     Revised Date:  2014-05-27    
Medline Journal Info:
Nlm Unique ID:  8503649     Medline TA:  Minerva Urol Nefrol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  37-50     Citation Subset:  IM    
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MeSH Terms
African Continental Ancestry Group / genetics
Allopurinol / therapeutic use
Antihypertensive Agents / therapeutic use
Apolipoproteins / genetics,  physiology
Chronic Disease
Diabetic Angiopathies / complications,  physiopathology
Diabetic Nephropathies / physiopathology
Disease Management
Disease Models, Animal
Genetic Predisposition to Disease
Glomerulosclerosis, Focal Segmental / ethnology,  genetics
Hypertension / complications*,  drug therapy,  ethnology,  physiopathology
Hypertension, Renal / etiology,  physiopathology
Hyperuricemia / complications,  drug therapy,  epidemiology,  physiopathology
Intervention Studies
Kidney Diseases / complications*,  ethnology,  physiopathology
Lipoproteins, HDL / genetics,  physiology
Multicenter Studies as Topic
Polymorphism, Genetic
Randomized Controlled Trials as Topic
Grant Support
Reg. No./Substance:
0/APOL1 protein, human; 0/Antihypertensive Agents; 0/Apolipoproteins; 0/Lipoproteins, HDL; 63CZ7GJN5I/Allopurinol

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