Hypertension, type IV cardiorenal syndrome and chronic kidney disease: Pathophysiological and therapeutical approach

doi:10.5494/wjh.v7.i1.10

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World Journal of Hypertension

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World J Hypertens. Feb 23, 2017; 7(1): 10-18
Published online Feb 23, 2017. doi: 10.5494/wjh.v7.i1.10

Hypertension, type IV cardiorenal syndrome and chronic kidney disease: Pathophysiological and therapeutical approach

Luca Di Lullo, Antonio Bellasi, Antonio De Pascalis

Luca Di Lullo, Department of Nephrology and Dialysis, L. Parodi-Delfino Hospital, Colleferro, 00034 Rome, Italy

Antonio Bellasi, Department of Nephrology and Dialysis, ASST Lariana, 22100 Como, Italy

Antonio De Pascalis, Department of Nephrology, Dialysis and Transplantation, V. Fazzi Hospital, 73100 Lecce, Italy

Author contributions: Di Lullo L contributed to type IV cardiorenal syndrome; Bellasi A and De Pascalis A contributed to hypertension in CKD.

Conflict-of-interest statement: The authors have no conflict of interest.

Correspondence to: Dr. Luca Di Lullo, Department of Nephrology and Dialysis, L. Parodi-Delfino Hospital, Piazza A. Moro, 1, Colleferro, 00034 Rome, Italy. dilulloluca69@gmail.com

Telephone: +39-06-97223209 Fax: +39-06-97223213

Received: August 23, 2016
Peer-review started: August 25, 2016
First decision: September 27, 2016
Revised: November 6, 2016
Accepted: December 27, 2016
Article in press: December 28, 2016
Published online: February 23, 2017
Processing time: 177 Days and 2 Hours

Abstract

Hypertension represent one of the most important comorbid factors in chronic kidney disease (CKD) patients and its prevalence increases from 65% to 95% according to glomerular filtration rate decline. CKD patients need to maintain their blood pressure levels into 130/80 mmHg according to most recent guidelines. Despite of many therapeutic agents, achievement of ideal blood pressure levels remains so far from the ideal ones. Hypertensive disease represent most important risk factor to develop a type IV cardiorenal syndrome, while prevalence of end stage renal disease is still raising and it represents worldwide epidemiological challenge. Correct management of hypertensive disease can obtain better control on CKD progression.

Keywords: Hypertension; Type IV cardiorenal syndrome; Renin-angiotensin system inhibitors; Calcium channel blockers; Chronic kidney disease

Core tip: Treat hypertensive disease can delay chronic kidney disease progression and type IV cardiorenal syndrome onset.