Role of sodium restriction and diuretic therapy for "resistant" hypertension in chronic kidney disease.

Abstract:

:In patients with chronic kidney disease, an impaired capacity of the kidney to excrete sodium is a major contributor to hypertension. We discuss the role of sodium restriction and diuretic therapy for resistant hypertension in chronic kidney disease. Independent of increasing blood pressure, a sustained high sodium intake also may affect the progression of renal disease adversely. Consequently, dietary sodium restriction and appropriate diuretic therapy are the foundation for the treatment of resistant hypertension. Thiazide-like diuretics have decreasing effectiveness in patients with advancing renal disease; however, they may augment the effectiveness of the more potent loop diuretics. Increasing evidence suggests that spironolactone is an effective adjunct for the treatment of resistant hypertension. Inclusion of other classes of antihypertensive agents to the treatment regimen generally is necessary to counterbalance other mechanisms contributing to resistant hypertension. The effectiveness of these agents is enhanced by dietary sodium restriction and diuretic therapy.

journal_name

Semin Nephrol

journal_title

Seminars in nephrology

authors

Sinnakirouchenan R,Kotchen TA

doi

10.1016/j.semnephrol.2014.08.005

subject

Has Abstract

pub_date

2014-01-01 00:00:00

pages

514-9

issue

5

eissn

0270-9295

issn

1558-4488

pii

S0270-9295(14)00110-7

journal_volume

34

pub_type

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