Kidney and hypertension

In patients with chronic kidney disease elevated blood pressure is a common finding, but primary hypertension can also damage healthy kidneys. Renal outcome is strictly dependent on blood pressure, no matter whether the kidneys are cause or consequence of hypertension. Furthermore, hypertension and kidney disease are strong cardiovascular risk factors. In every patient diagnosed with hypertension glomerular filtration rate has to be checked. Proteinuria and structural abnormalities of the kidneys should be ruled out. Patients with a decreased glomerular filtration rate, proteinuria or pathologic ultrasound should be seen by a nephrologist. A strict antihypertensive therapy (blood pressure < 130/80 mmHg) can substantially improve the prognosis of hypertensive renal patients. In patients with kidney damage, inhibitors of the renin-angiotensin-system are preferred. To avoid adverse events a close monitoring of antihypertensive therapy is warranted.