Blood Pressure Control for Polycystic Kidney Disease

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Rudolf P. Wüthrich
Andreas D. Kistler
Daniel Rodriguez
Sarika Kapoor
Changlin Mei

ABSTRACT


Autosomal dominant polycystic kidney disease (ADPKD) is the most prevalent genetic kidney disease and affects 6 to 12 million patients worldwide. The disease is characterized by the progressive development of innumerable renal cysts that gradually replace normal kidney tissue, leading ultimately to the loss of renal function starting from the 5th decade of life. Most patients with ADPKD develop arterial hypertension. High blood pressure develops early in the course of the disease and is caused by the activation of the renin-angiotensin-aldosterone system (RAAS) and other significant pathogenic mechanisms. Hypertension is a major contributing factor for the increased cardiovascular morbidity and mortality in patients with ADPKD. Optimal treatment of hypertension is essential to improve the prognosis of the cystic disease and the associated cardiovascular diseases. Target blood pressures and choice of antihypertensive drugs for patients with ADPKD have not been firmly defined in guidelines, but the recently published results from the HALT-PKD studies suggest that a blood pressure goal of <130/80 mm Hg should be targeted, preferably with inhibitors of the RAAS.

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Section
Chapter 5