THE ROLE OF HYPERTENSION IN RENAL COMPLICATIONS AND PROGRESSION OF RENAL DAMAGE

The risk of hypertension induced renal damage sufficient to result in ESRD is a broad spectrum problem. The risk is relatively small in the general population with essential hypertension in the absence of malignant nephrosclerosis;it is increased substantially in certain populations and is gretatest in patients with co-existent chronic renal disease and/or diabetes, particularly if they belong to a susceptible racial/ethnic group. Hypertension is estimated to be present in 90% of patients with end stage renal disease. Antihyperiensive theraphy is the cornerstone of renoprotection. Angiotensin II is a main mediator of glomerular hemodynamic adaptation in renal damage. Most of the antihyperiensive agents (except dihydropyridines) have a similar protecting effect on the kidney if optimal blood pressure is obtained. Recent data have suggested more agressive blood pressure control exhibited a strong renoprotective effect