Target blood pressure for antihypertensive therapy in patients with proteinuric Renal Disease

被引：5

作者：

Hebert L.A. ^{[1
]}

机构：

[1] Ohio State University, Columbus

来源：

Current Hypertension Reports | 1999年 / 1卷 / 5期

基金：

美国国家卫生研究院;

关键词：

Proteinuria; Mean Arterial Pressure; Blood Pressure Control; Target Blood Pressure; Blood Pressure Goal;

D O I：

10.1007/s11906-999-0063-0

中图分类号：

学科分类号：

摘要：

The Modification of Diet in Renal Disease (MDRD) study showed for the first time that controlling blood pressure is critically important in slowing the progression of proteinuric renal disease (24-h proteinuria of 1.0 g or more). Furthermore, it was found that the greater proteinuria, the more important it was to achieve excellent blood pressure control. The MDRD analysis also suggested that this paradigm may be particularly important for blacks with proteinuric renal disease. Surprisingly, the MDRD data showed that a blood pressure of 125/75 mm Hg was superior to a blood pressure of 135/85 mm Hg in slowing the progression of renal disease. Thus, so-called hypercontrol of blood pressure is needed to slow the progression of proteinuric renal disease. Studies in patients with diabetic glomerulosclerosis also have provided evidence as to the importance of achieving the low blood pressure goal to slow the progression of the glomerulopathy. In summary, strict control of blood pressure (125/75 mm Hg or less, if tolerated) is recommended to slow the progression of proteinuric renal disease. Furthermore, the greater the proteinuria, the more important it is to achieve this target blood pressure to slow the progression of renal disease. Copyright © 1999 by Current Science, Inc.

引用

页码：454 / 460

页数：6

共 21 条

[1]

Brazy P.C., Stead W.W., Fitzwilliam J.F., Progression of renal insufficiency: Role of blood pressure, Kidney Int, 35, pp. 670-674, (1998)

[2]

Klahr S., Levey A.S., Beck G.J., Et al., The effects of dietary protein restriction and blood pressure control on the progression of chronic renal disease. Modification of Diet in Renal Disease Study Group, N Engl J Med, 330, pp. 877-884, (1994)

[3]

Peterson J.C., Adler S., Burkart J.M., Et al., Blood pressure control, proteinuria, and the progression of renal disease. The Modification of diet in Renal Disease Study, Ann Intern Med, 123, pp. 754-762, (1995)

[4]

Burton C., Harris K.P.G., The role of proteinuria in the progres sion of chronic renal failure, Am J Kidney Dis, 27, pp. 765-775, (1996)

[5]

Remuzzi G., Ruggenenti P., Benigni A., Understanding the nature of renal disease progression, Kidney Int, 51, pp. 2-15, (1997)

[6]

Abbate M., Zoja C., Rottoli D., Et al., Antiproteinuric therapy while preventing the abnormal protein traffic in proximal tubule abrogates protein and complement dependent inter stitial inflammation in experimental renal disease, J Am Soc Nephrol, 10, pp. 804-813, (1999)

[7]

Apperloo A.J., De Zeeuw D., De Jong P.E., Short-term antiproteinuric response to antihypertensive treatment predicts long term GFR decline in patients with nondiabetic renal disease, Kid Ney Int, 45, SUPPL. 45, (1994)

[8]

Rossing P., Hommel E., Smidt U.M., Parving H.-H., Reduction in albuminuria predicts diminished progression in diabetic nephropathy, Kidney Int, 45, SUPPL. 45, (1994)

[9]

Hebert L.A., Bain R.P., Verme D., Et al., Remission of nephrotic range proteinuria in type I diabetes, Kidney Int, 46, pp. 1688-1693, (1994)

[10]

Estacio R.O., Jeffers B.W., Hiatt W.R., Et al., The effect of nisoldipine as compared with enalapril on cardiovascular out comes in patients with non insulin dependent diabetes and hypertension, N Engl J Med, 338, pp. 645-651, (1998)

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