Control of hypertension in patients with chronic renal failure
Robert J. Heyka, MDAddress reprint requests to R.J.H., Department of Hypertension and Nephrology, The Cleveland Clinic Foundation, One Clinic Center, 9500 Euclid Avenue, Cleveland, Ohio 44195.
Donald G. Vidt, MD
Hypertension related to renal parenchymal disease is the most common cause of secondary hypertension. Poor control of renal hypertension is associated with an increased risk for progressive atherosclerosis and progressive renal failure. This review discusses the prevalence, significance, and pathophysiology of renal hypertension. Treatment options, both dietary and pharmacologic, are reviewed. Special emphasis is given to important pharmacokinetic changes in chronic renal failure. Treatment of hypertensive urgencies and emergencies in this population is also reviewed.