Article Dans Une Revue Nephrology Dialysis Transplantation Année : 2014

A European Renal Best Practice (ERBP) position statement on the Kidney Disease: Improving Global Outcomes (KDIGO) clinical practice guideline for the management of blood pressure in non-dialysis-dependent chronic kidney disease: an endorsement with some caveats for real-life application

F. Verbeke
  • Fonction : Auteur
E. Lindley
  • Fonction : Auteur
L. van Bortel
  • Fonction : Auteur
R. Vanholder
  • Fonction : Auteur
G. London
  • Fonction : Auteur
P. Cochat
A. Wiecek
  • Fonction : Auteur
W. van Biesen
  • Fonction : Auteur

Résumé

Developing guidelines on a subject as broad as hypertension is difficult, especially when the guidance relates to hypertension in the chronic kidney disease (CKD) population. The Kidney Disease: Improving Global Outcomes Guideline Development Group has applied a rigorous methodology in reviewing all available evidence, and their recommendations are consistent with the evidence-based approach. As a result, the European Renal Best Practice endorses most of its recommendations. However, the Work Group feels that some additional advice could help clinicians in daily practice: (i) individualization of treatment should be taken into account, especially (cardiovascular) co-morbidities, age, gender and race; (ii) side-effects, such as postural dizziness should be monitored closely, particularly in elderly, diabetics and patients with arterial stiffness; (iii) the importance of salt restriction should not be neglected; (iv) although angiotensin-converting enzyme inhibitors (ACE-Is) and angiotensin receptor blocker (ARBs) remain a cornerstone in the management of hypertension, and especially cardiovascular protection, in some particular situations such as in advanced CKD and in patients without proteinuria, their role is less well defined; (v) as most CKD patients need more than one antihypertensive drug to achieve blood pressure control, the specific (renal) (dis)advantages of other classes than ACE-I or ARB should be taken into account.

Dates et versions

hal-01859005 , version 1 (21-08-2018)

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Citer

F. Verbeke, E. Lindley, L. van Bortel, R. Vanholder, G. London, et al.. A European Renal Best Practice (ERBP) position statement on the Kidney Disease: Improving Global Outcomes (KDIGO) clinical practice guideline for the management of blood pressure in non-dialysis-dependent chronic kidney disease: an endorsement with some caveats for real-life application. Nephrology Dialysis Transplantation, 2014, 29 (3), pp.490-6. ⟨10.1093/ndt/gft321⟩. ⟨hal-01859005⟩
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