Managing Arterial Hypertension in Chronic Renal Failure: Myths, Mechanisms, and Therapeutic Realities - PubMed
8 days ago
- #chronic kidney disease
- #renal denervation
- #hypertension
- Hypertension is highly prevalent in chronic kidney disease (CKD) patients, contributing to cardiovascular morbidity and renal decline.
- Key mechanisms include volume overload, RAAS activation, sympathetic overactivity, and vascular dysfunction.
- Diagnostic challenges include white-coat hypertension and underuse of ambulatory monitoring.
- Management involves lifestyle changes, pharmacotherapy (RAAS inhibitors, diuretics, novel agents), and device-based interventions like renal denervation (RDN).
- Special considerations for transplant recipients, elderly, and dialysis patients are highlighted.
- Misconceptions about RAAS blockade, dialysis hypotension, and therapeutic inertia are critically reviewed.
- Future directions include biomarker-driven approaches, digital health, and large-scale RDN trials.