the ways to treat high blood pressure in kidney disease

CKD hypertension treatment

CKD hypertension treatment

     Target for blood pressure

     1. No albuminuria CKD patients continued ≤140 / 90 mmHg.

     2. albuminuria and kidney transplant patients with CKD sustained ≤130 / 80 mmHg.

     Drug

     1. No albuminuria and kidney transplant patients with CKD, according to patient complications and all other antihypertensive drugs to choose the right medication.

     2. CKD patients with albuminuria preferred angiotensin Ⅱ receptor antagonist (ARB) and (or) an angiotensin converting enzyme inhibitor (ACEI).

     3. Determine the patient's blood pressure and target for therapy (unfractionated) based on age, pulse pressure, cardiovascular disease and other coexisting comorbidities, as well as the risk of CKD progression, individualized.

     4. When using antihypertensive medication CKD patients should be regularly orthostatic dizziness and orthostatic hypotension detection (unrated).

     5. Encourage patients with CKD ND route through lifestyle changes to lower blood pressure, in order to improve the long-term cardiovascular and other physiological outcomes:

     ① recommended to achieve or maintain body mass index of 20 ~ 25 (1D);

     ② unless contraindicated, is recommended low-salt diet (sodium <2.4 g / d) (1C);

     ③ In the case of cardiovascular and endurance permitting, recommend at least 5 times a week, each lasting 30 minutes of exercise (1D);

     ④ recommended that men limit daily alcohol intake of no more than 20 g, women no more than 10 g (1D).

     6. For urinary albumin <30 mg / d and nondiabetic CKD ND patients, if the systolic blood pressure and (or) lasts more than 140 mmHg and diastolic blood pressure (or) 90 mmHg, it is recommended that the use of antihypertensive drugs blood pressure continuously ≤ 140/90 mmHg (1B).

     7. For the urinary albumin is 30 ~ 300 mg / d and nondiabetic CKD ND patients, if the systolic blood pressure and (or) lasts more than 130 mmHg and diastolic blood pressure (or) 80 mmHg, it is recommended that the use of antihypertensive drugs in blood pressure continuing ≤130 / 80 mmHg (2D).

     8. For the urinary albumin> 300 mg / d and non-diabetic CKD ND patients, if the systolic blood pressure and (or) lasts more than 130 mmHg and diastolic blood pressure (or) 80 mmHg, it is recommended that the use of antihypertensive drugs to maintain blood pressure in 130/80 mmHg levels (2C).

     9. For the urinary albumin is 30 ~ 300 mg / d and non-diabetic patients with CKD ND, ARB or ACEI is recommended as the first choice of antihypertensive drugs (2D).

     10. For the urinary albumin> 300 mg / d and non-diabetic patients with CKD ND, ARB or ACEI is recommended as the first choice of antihypertensive drugs (1B).