Hypertension in chronic kidney disease

CKD is leading cause of secondary hypertension. Prevalence of hypertension in Indian urban population is appox. 20–40% whereas in CKD its prevalence is much higher depending on stage of CKD reaching about 90% in ESRD. Hypertension, besides proteinuria is one of important factor in progression of CKD and CVD risk. Thus it has pivotal role in outcome of CKD and ESRD patients. Large number of studies has shown that effective control of blood pressure retards progression of renal disease and lower blood pressure targets have more favorable outcome, especially in proteinuric patients. The cardiovascular mortality is much higher in CKD than general population, but there are no large studies in CKD population to ascertain optimal blood pressure in reducing cardiovascular mortality in this group. The understanding of hypertension and target blood pressure level to be achieved in CKD and ESRD patients in terms of retarding the progression of renal disease and reducing the CVD events in this population has been discussed with the available evidences.