An Editorial Update: What Level of Blood Pressure Control in Chronic Kidney Disease?
Authors: Andrew S. Levey, Cynthia D. Mulrow
Journal: Annals of Internal Medicine (2005)

Editorials5 July 2005An Editorial Update: What Level of Blood Pressure Control in Chronic Kidney Disease?Andrew S. Levey, MD and Cynthia D. Mulrow, MD, MSc, Deputy EditorAndrew S. Levey, MDFrom Tufts-New England Medical Center, Boston, MA 02111, and the American College of Physicians, Philadelphia, PA 19106.Search for more papers by this author and Cynthia D. Mulrow, MD, MSc, Deputy EditorFrom Tufts-New England Medical Center, Boston, MA 02111, and the American College of Physicians, Philadelphia, PA 19106.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-143-1-200507050-00013 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Chronic kidney disease affects about 11% of adults in the United States (1). Hypertension causes about 20% of new cases of kidney failure and complicates 60% to 80% of cases of chronic kidney disease caused by other disorders (2). Irrespective of the cause of chronic kidney disease, hypertension increases the risk for important adverse outcomes, such as progressive loss of kidney function and kidney failure, early development and accelerated progression of cardiovascular disease, and premature death. Angiotensin-converting enzyme (ACE) inhibitors are recommended in chronic kidney disease because in addition to lowering blood pressure, they reduce proteinuria, slow the decline of ...References1. National Kidney Foundation. K/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification and stratification. Am J Kidney Dis. 2002;39 Suppl 1 S1-266. [PMID: 11904577] MedlineGoogle Scholar2. Kidney Disease Outcomes Quality Initiative (K/DOQI). K/DOQI clinical practice guidelines on hypertension and antihypertensive agents in chronic kidney disease. Am J Kidney Dis. 2004;43 Suppl 1 S1-290. [PMID: 15114537] MedlineGoogle Scholar3. Jafar TH, Schmid CH, Landa M, Giatras I, Toto R, Remuzzi G, et al. Angiotensin-converting enzyme inhibitors and progression of nondiabetic renal disease. A meta-analysis of patient-level data. Ann Intern Med. 2001;135:73-87. [PMID: 11453706] LinkGoogle Scholar4. Sarnak MJ, Greene T, Wang X, Beck G, Kusek JW, Collins AJ, et al. The effect of a lower target blood pressure on the progression of kidney disease: long-term follow-up of the Modification of Diet in Renal Disease Study. Ann Intern Med. 2005;142:342-51. [PMID: 15738453] LinkGoogle Scholar5. Ruggenenti P, Perna A, Loriga G, Ganeva M, Ene-Iordache B, Turturro M, et al. Blood-pressure control for renoprotection in patients with non-diabetic chronic renal disease (REIN-2): multicentre, randomised controlled trial. Lancet. 2005;365:939-46. [PMID: 15766995] CrossrefMedlineGoogle Scholar6. Wright JT, Bakris G, Greene T, Agodoa LY, Appel LJ, Charleston J, et al. Effect of blood pressure lowering and antihypertensive drug class on progression of hypertensive kidney disease: results from the AASK trial. JAMA. 2002;288:2421-31. [PMID: 12435255] CrossrefMedlineGoogle Scholar7. Klahr S, Levey AS, Beck GJ, Caggiula AW, Hunsicker L, Kusek JW, et al. The effects of dietary protein restriction and blood-pressure control on the progression of chronic renal disease. Modification of Diet in Renal Disease Study Group. N Engl J Med. 1994;330:877-84. [PMID: 8114857] CrossrefMedlineGoogle Scholar8. Jafar TH, Stark PC, Schmid CH, Landa M, Maschio G, de Jong PE, et al. Progression of chronic kidney disease: the role of blood pressure control, proteinuria, and angiotensin-converting enzyme inhibition: a patient-level meta-analysis. Ann Intern Med. 2003;139:244-52. [PMID: 12965979] LinkGoogle Scholar9. Levey AS. Clinical practice. Nondiabetic kidney disease. N Engl J Med. 2002;347:1505-11. [PMID: 12421894] MedlineGoogle Scholar10. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003;289:2560-72. [PMID: 12748199] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Tufts-New England Medical Center, Boston, MA 02111, and the American College of Physicians, Philadelphia, PA 19106.Acknowledgment: The authors thank Tom Greene, PhD, for his careful review and helpful comments during preparation of this editorial.Disclosures: Dr. Levey was an investigator in the Modification of Diet in Renal Disease Study.Corresponding Author: Andrew S. Levey, MD, Division of Nephrology, Tufts-New England Medical Center, 750 Washington Street, Boston, MA 02111.Current Author Addresses: Dr. Levey: Division of Nephrology, Tufts-New England Medical Center, 750 Washington Street, Boston, MA 02111.Dr. Mulrow: American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106-1572. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byKidneyTratamiento de la insuficiencia renal crónica en atención primariaWhich Antihypertensive Agents in Chronic Kidney Disease?Andrew S. Levey, MD and Katrin Uhlig, MD, MSThe Effect of a Lower Target Blood Pressure on the Progression of Kidney Disease: Long-term Follow-up of the Modification of Diet in Renal Disease StudyHypertension: A Review and Rationale of Treatment 5 July 2005Volume 143, Issue 1Page: 79-81KeywordsACE inhibitorsBlood groupsBlood pressureCardiovascular diseasesChronic kidney diseaseGlomerular filtration rateHypertensionProteinuriaRenal diseasesRenal failure ePublished: 5 July 2005 Issue Published: 5 July 2005 Copyright & PermissionsCopyright © 2005 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...