Oct 13, 2025
3 min read
Good blood pressure control in CKD can be significantly reduced.What strategies are accompanied by their goals.
Berlin - To the patients and letters of the kidney letters, a high form of the increase in the driver of the driving action.Marus van der Gie de Charité - Mamarine's Annual University [1].
"We have long been a long time that the Cuck progress has been influenced by CKD -progress, but it is still different with it," he said.
Although the European Hypertensius Society (ESH) now is the relatively conservative (target value <140 mm Hg, high-risk patients <130 mm Hg), the European Cardiology Society (ESC) 120 in 129 mm Hg, American Hart and 120 mm Hg Association (ACC/ACH/ACH/ACH/ACH/ACH/MMG’s recommendation.
There is a clear tendency at 120 mmhg
"The visible change is to try to reach 120 mm hg hg." Van Dett said.Systolic value is especially important in the kidneys.The cost of the price of most of the instructions is defined by 80 to 90 mmHG., And in some cases is not identified at all.
The tender is tender: We try to get about 120 mmg.
Professor Dr. Marcus Von Ter Keith
The first step to minimize blood pressure in all guidelines, avoiding alcohol and cigarettes in the meal - as well as the air and the air.
"This can only be done for most patients for the limited level of these funds.Then it will remain the capacity of medicines, "said Van der Gibber
To adapt medication therapy to the CKD stage
The role of renin-angiotensin-aldosterone inhibitors (Raas) is the central point for KKD hypertension therapy: "angiotensin has a contractile effect, especially in Eferens.
Besides, the uni-condition that is dependent, is dependent on the CD stage of the CD.For patients with 1 to 3cd (estimated sparkling Filetrans ranges [Egrfr] ≥00 M2) and a combination of the Education
If the blood pressure is too many blood pressure, many with many with a lot of blood pressure or stole and knige and knight and knight, soldier and bluts and bluts and fluts and bluts and bluts.
For Stage 4 and 5 CKD (EGF), insufficiently, the gap, space care, gaps, loop spaces
"The knee diuretics have stronger power of the bottom of the heat," Van der Giiet explained a different approach.
In practice, general problem: Practical: If the kidneys operate, the kidney operation will reduce the 4 CKD page.
When 3 medicines are not enough
Despite the triple optimal therapy, some patients with CKD do not achieve target values.The causes include vascular rigidity, sympathetic hyperactivity, and retention of sodium and liquids.About 10% to 20% of patients initially occur with apparently resistant hypertension.Secondary to high blood pressure, hypertension resistant to "true" can be confirmed in approximately 5% of patients.
"We need a fourth medicine for the patient," said Van der giet.Spironolactone is shown to be the most effective option in the annual 2015 2015 study - in patients with healthy kidney function.
We need four species for these patients.
By pro.tr.mark van der get
Spironolctone or compensation can help with resistant
This applies to patients with CKD in stages 1 to 3. If high blood pressure is resistant to treatment, these drugs should be used inspirolocoloconeespeciallyIn addition to triple therapy, preferably a mineralcorticoid receptor antagonist (MRA) should be used.
However, in the CKD 4 - 5 stages, the use of MRA is problematic because of the risk of hyperkalemia, Van der Giet said.Chlorhalidone could be an option here: in Click study, diuretics such as thiazides have reduced systolic blood pressure by about 10 mmHg after 12 to 14 weeks - without evidence of accelerated renal function.
SGLT -2 Tyrant and Finainrentone can share this environment and reduces the pressure pressure for the pressure for the pressure.
New ways to cross ras
The focus will be on future developments in the siege of Aldostoone."The aldosterone product is formed not only by Raas, but also by other factors," van der G. explained, "it is the action of immune cells and causes direct organ damage to the kidneys, heart and vessels."
An example of this is an Eldosterone cytteris Anubiators, such as production of adrenal gland.In the initial study in CKD and hypertlollable patients, blood pressure reduction by 10 mm hg and about 60%.
He can also look for wounds in the future.In addition to weight, GLP-1 / GPSPPPERS 6 / GIPPPPERS 6 / GIPPPPERS 6 / GIPSPPPPERS 6 / GIPSPPPPERS seem to have a very useful impact.
Metal analysis of a more than 30,000 participants, which are also presented on the congress - in hypertension - left a drop., But were correlated by weight calls, supported by torque levels at Tissue levels."
Perhaps we can guide the patient's resistance in the future with weight weight.
Prof.Dr.Markus Van der Giet
