Hypertension in Renal Disease: Pathogenesis and Management

^Authors: Gretta Niken Purbosari¹, Khoirunnisa¹, Suharjono^2*

¹Master of Clinical Pharmacy, Faculty of Pharmacy,

²Department Of Clinical Pharmacy, Faculty of Pharmacy,

Airlangga University, 60286, Surabaya, Indonesia

Email: shj_ms_id@yahoo.co.id, grettaniken@gmail.com

Abstract

Hypertension occurs in more than 80% of patients with chronic renal failure. The role of kidney in renal disease-related hypertension is very complex. Exogenous and endogenous factors may affect blood pressure in patients with renal disease, including high sodium intake, increased sympathetic nervous system activity, increased renin-angiotensin-aldosterone system activity, and endothelial dysfunction. In some cases, it becomes difficult to determine whether hypertension or renal disease is the underlying disorder. In addition to lifestyle and dietary modifications, pharmacological therapy is an important component in controlling and achieving blood pressure targets. The overall goal of hypertension therapy in renal disease is to prevent extrarenal complications from hypertension, such as heart disease and stroke. In all patients with renal disease, blood pressure should be controlled at the recommended level. Some guidelines for chronic renal disease patients recommend to start the therapy using ACE-I or ARB, or adding ACE-I or ARB to the patient’s drug regimen.

Keywords: Hypertension, Renal Disease, Hypertension Management

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