2009;87:1040–4. (Level 4) 7. Moore J, et al. Clin Transplant. 2011;25:406–16. (Level 4) 8. Tonelli M, et al. Circulation. 2005;112:2627–33. (Level
4) 9. Abramowitz M, et al. Clin J Am Soc Nephrol. 2010;5:1064–71. (Level 4) 10. Dhingra R, et al. Arch Intern Med. 2007;167:879–85. (Level 4) 11. Larsson TE, et al. Arterioscler Thromb Vasc Biol. 2010;30:333–9. (Level 4) 12. Menon V, et al. Am J Kidney Dis. 2005;46:455–63. (Level 4) 13. Murtaugh MA, et al. Nephrol Dial Transplant. 2012;27:990–6. (Level 4) 14. Smith DH, et al. Nephrol Dial Transplant. 2010;25:166–74. (Level Selleckchem CA3 4) 15. Schwarz S, et al. Clin J Am Soc Nephrol. 2006;1:825–31. (Level 4) 16. Zoccali C, et al. J Am Soc Nephrol. 2011;22:1923–30. (Level 4) 17. O’Seaghdha CM, et al. Nephrol Dial Transplant. 2011;26:2885–90. (Level 4) 18. Chue CD, et al. Nephrol Dial Transplant. 2011;26:2576–82. (Level 4) 19. Sullivan C, et al. JAMA. 2009;301:629–35. (Level 2) 20. Moe SM, et al. Clin J Am Soc Nephrol. 2011;6:257–64. (Level 3) Chapter 4: Hypertension and CVD in CKD Does hypertension cause or aggravate CKD? Hypertension causes CKD and exacerbates its clinical condition. Inversely, CKD causes hypertension and is a risk factor that can aggravate hypertension. In the MRFIT study and prospective CX-5461 clinical trial cohort studies, hypertension was found to be a significant
risk factor for end-stage kidney disease (ESKD) regardless of gender. When Ribonucleotide reductase the systolic blood pressure (BP) was elevated by 10 mmHg, the onset of ESKD Selleck GSK126 was increased by 20–30 %. In addition, while the 10-year hazard ratio (HR) for the occurrence of G1 or G2 category of CKD is 1.21–1.67 with grade I hypertension (JSH2009), it increases to 1.73–2.17 with grade II-III hypertension. In addition, in an observational study of
patients with hypertension without CKD, the renal function deteriorated in patients with inadequate lowering of their blood pressure. Furthermore, it is important to diagnose hypertension at an early phase and to start appropriate anti-hypertensive therapy to prevent the progression of CKD to ESKD. Bibliography 1. Klag MJ, et al. N Engl J Med. 1996;334:13–8. (Level 4) 2. Klag MJ, et al. JAMA 1997;277:1293–8. (Level 4) 3. Reynolds K, et al. J Am Soc Nephrol. 2007;18:1928–35. (Level 4) 4. Tozawa M, et al. Hypertension. 2003;41:1341–5. (Level 4) 5. Yamagata K, et al. Kidney Int. 2007;71:159–66. (Level 4) 6. The Centers for Disease Control and Prevention Chronic Kidney Disease Surveillance Team. Hypertension. 2010;55:1102–9. (Level 4) 7. Vupputuri S, et al. Hypertension. 2003;42:1144–9. (Level 4) 8. Yano Y, et al. Kidney Int. 2012;81:293–9. (Level 4) Is anti-hypertensive therapy recommended for the management of CKD? (Fig. 1) 1. Recommendation of anti-hypertensive therapy The aim of anti-hypertensive therapy is to inhibit the progression of CKD and to decrease the occurrence of CVD and mortality.