The chaos of hypertension guidelines for chronic kidney disease patients

Three major guidelines deal with blood pressure thresholds and targets for antihypertensive drug therapy in chronic kidney disease (CKD) patients: the 2012 Kidney Disease: Improving Global Outcomes Clinical Practice Guideline for the Management of Blood Pressure in Chronic Kidney Disease; the 2017 A...

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Authors: Castillo-Rodriguez, Esmeralda, Fernández Fernández, Beatriz, Alegre-Bellassai, Raquel, Kanbay, Mehmet, Ortiz Arduán, Alberto
Format: article
Publication Date:2019
Country:España
Institution:Universidad Autónoma de Madrid
Repository:Biblos-e Archivo. Repositorio Institucional de la UAM
Language:English
OAI Identifier:oai:repositorio.uam.es:10486/691850
Online Access:http://hdl.handle.net/10486/691850
https://dx.doi.org/10.1093/ckj/sfz126
Access Level:Open access
Keyword:blood pressure targets
blood pressure thresholds
chronic kidney disease
hypertension
renin-angiotensin system
treatment
Medicina
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spelling The chaos of hypertension guidelines for chronic kidney disease patientsCastillo-Rodriguez, EsmeraldaFernández Fernández, BeatrizAlegre-Bellassai, RaquelKanbay, MehmetOrtiz Arduán, Albertoblood pressure targetsblood pressure thresholdschronic kidney diseasehypertensionrenin-angiotensin systemtreatmentMedicinaThree major guidelines deal with blood pressure thresholds and targets for antihypertensive drug therapy in chronic kidney disease (CKD) patients: the 2012 Kidney Disease: Improving Global Outcomes Clinical Practice Guideline for the Management of Blood Pressure in Chronic Kidney Disease; the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults; and the 2018 ESC/ESH Guidelines for the Management of Arterial Hypertension. However, a careful reading of the three guidelines leaves the practicing physician confused about the definition of CKD, how hypertension and secondary hypertension should be diagnosed in CKD patients and what the blood pressure thresholds, targets and compelling indications of antihypertensive drug therapy should be for this population. Current guidelines refer to different CKD populations and propose different definitions of hypertension, different thresholds to initiate antihypertensive therapy in CKD patients and different BP targets compelling antihypertensive drug use. The different bodies producing guidelines should work together towards a unified definition of CKD, a unified concept of hypertension and unified BP thresholds and targets for hypertensive drug therapy for CKD patients. Otherwise they risk promoting confusion and therapeutic nihilism among physicians and patientsResearch by the authors was supported by FIS CP14/00133, PI16/02057, PI18/01366, PI19/00588, PI19/00815, DTS18/00032, ERA-PerMed-JTC2018 (KIDNEY ATTACK AC18/00064 and PERSTIGAN AC18/00071), ISCIII-RETIC REDinREN RD016/0009 Fondos FEDER, FRIAT, Sociedad Española de Nefrología, Comunidad de Madrid B2017/BMD-3686 CIFRA2-CMOxford University Press (OUP)European Renal Association - European Dialysis and Transplant Association (ERA-EDTA)Departamento de MedicinaFacultad de Medicina20192019-09-28research articlehttp://purl.org/coar/resource_type/c_2df8fbb1VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10486/691850https://dx.doi.org/10.1093/ckj/sfz126reponame:Biblos-e Archivo. Repositorio Institucional de la UAMinstname:Universidad Autónoma de MadridInglésengopen accesshttp://purl.org/coar/access_right/c_abf2info:eu-repo/semantics/openAccessoai:repositorio.uam.es:10486/6918502026-06-23T12:46:27Z
dc.title.none.fl_str_mv The chaos of hypertension guidelines for chronic kidney disease patients
title The chaos of hypertension guidelines for chronic kidney disease patients
spellingShingle The chaos of hypertension guidelines for chronic kidney disease patients
Castillo-Rodriguez, Esmeralda
blood pressure targets
blood pressure thresholds
chronic kidney disease
hypertension
renin-angiotensin system
treatment
Medicina
title_short The chaos of hypertension guidelines for chronic kidney disease patients
title_full The chaos of hypertension guidelines for chronic kidney disease patients
title_fullStr The chaos of hypertension guidelines for chronic kidney disease patients
title_full_unstemmed The chaos of hypertension guidelines for chronic kidney disease patients
title_sort The chaos of hypertension guidelines for chronic kidney disease patients
dc.creator.none.fl_str_mv Castillo-Rodriguez, Esmeralda
Fernández Fernández, Beatriz
Alegre-Bellassai, Raquel
Kanbay, Mehmet
Ortiz Arduán, Alberto
author Castillo-Rodriguez, Esmeralda
author_facet Castillo-Rodriguez, Esmeralda
Fernández Fernández, Beatriz
Alegre-Bellassai, Raquel
Kanbay, Mehmet
Ortiz Arduán, Alberto
author_role author
author2 Fernández Fernández, Beatriz
Alegre-Bellassai, Raquel
Kanbay, Mehmet
Ortiz Arduán, Alberto
author2_role author
author
author
author
dc.contributor.none.fl_str_mv Departamento de Medicina
Facultad de Medicina
dc.subject.none.fl_str_mv blood pressure targets
blood pressure thresholds
chronic kidney disease
hypertension
renin-angiotensin system
treatment
Medicina
topic blood pressure targets
blood pressure thresholds
chronic kidney disease
hypertension
renin-angiotensin system
treatment
Medicina
description Three major guidelines deal with blood pressure thresholds and targets for antihypertensive drug therapy in chronic kidney disease (CKD) patients: the 2012 Kidney Disease: Improving Global Outcomes Clinical Practice Guideline for the Management of Blood Pressure in Chronic Kidney Disease; the 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults; and the 2018 ESC/ESH Guidelines for the Management of Arterial Hypertension. However, a careful reading of the three guidelines leaves the practicing physician confused about the definition of CKD, how hypertension and secondary hypertension should be diagnosed in CKD patients and what the blood pressure thresholds, targets and compelling indications of antihypertensive drug therapy should be for this population. Current guidelines refer to different CKD populations and propose different definitions of hypertension, different thresholds to initiate antihypertensive therapy in CKD patients and different BP targets compelling antihypertensive drug use. The different bodies producing guidelines should work together towards a unified definition of CKD, a unified concept of hypertension and unified BP thresholds and targets for hypertensive drug therapy for CKD patients. Otherwise they risk promoting confusion and therapeutic nihilism among physicians and patients
publishDate 2019
dc.date.none.fl_str_mv 2019
2019-09-28
dc.type.none.fl_str_mv research article
http://purl.org/coar/resource_type/c_2df8fbb1
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv http://hdl.handle.net/10486/691850
https://dx.doi.org/10.1093/ckj/sfz126
url http://hdl.handle.net/10486/691850
https://dx.doi.org/10.1093/ckj/sfz126
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Oxford University Press (OUP)
European Renal Association - European Dialysis and Transplant Association (ERA-EDTA)
publisher.none.fl_str_mv Oxford University Press (OUP)
European Renal Association - European Dialysis and Transplant Association (ERA-EDTA)
dc.source.none.fl_str_mv reponame:Biblos-e Archivo. Repositorio Institucional de la UAM
instname:Universidad Autónoma de Madrid
instname_str Universidad Autónoma de Madrid
reponame_str Biblos-e Archivo. Repositorio Institucional de la UAM
collection Biblos-e Archivo. Repositorio Institucional de la UAM
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,301603

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