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Hypertension management in acute kidney injury
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Abstract
Despite the fact that in recent years the concept of hypertension treatment has been verified and the management in special situations and groups of patients has been standardized , there are not many reports of antihypertensive therapy in patients with acute kidney injury. Acute renal failure, defined as a sudden decline of kidney function, is a clinical syndrome of various etiologies, often accompanies by hypertension, and specific pathological mechanism determines the therapeutic management. Diuretics are first-line drugs, particularly preferred in patients with volume overload. RAA blockers are not recommended for the hypertension treatment in acute kidney injury, but the broad definition of AKI forces individualization of therapy in various clinical situations - the results of large clinical trials show the benefits of ACE inhibitors in cases of HTA associated with acute glomerulopathies or vasculitis. Prevalence of drugs that affect potassium levels contribute to the rising incidence of hyperkalemia, which can be a consequence of both — acute and chronic kidney diseases. In case of a dynamically growing levels of potassium in AKI there is a need to decrease the dose or withdrawal of RAA blockers and mineralocorticoid antagonists.
Abstract
Despite the fact that in recent years the concept of hypertension treatment has been verified and the management in special situations and groups of patients has been standardized , there are not many reports of antihypertensive therapy in patients with acute kidney injury. Acute renal failure, defined as a sudden decline of kidney function, is a clinical syndrome of various etiologies, often accompanies by hypertension, and specific pathological mechanism determines the therapeutic management. Diuretics are first-line drugs, particularly preferred in patients with volume overload. RAA blockers are not recommended for the hypertension treatment in acute kidney injury, but the broad definition of AKI forces individualization of therapy in various clinical situations - the results of large clinical trials show the benefits of ACE inhibitors in cases of HTA associated with acute glomerulopathies or vasculitis. Prevalence of drugs that affect potassium levels contribute to the rising incidence of hyperkalemia, which can be a consequence of both — acute and chronic kidney diseases. In case of a dynamically growing levels of potassium in AKI there is a need to decrease the dose or withdrawal of RAA blockers and mineralocorticoid antagonists.
Keywords
AKI, acute renal failure, hypertension
About this articleTitle
Hypertension management in acute kidney injury
Journal
Issue
Article type
Case report
Pages
203-206
Published online
2015-11-18
Page views
3252
Article views/downloads
2075
DOI
10.5603/AH.2015.0026
Bibliographic record
Arterial Hypertension 2015;19(4):203-206.
Keywords
AKI
acute renal failure
hypertension
Authors
Marta Sołtysiak
Krystyna Widecka