Hipertensión arterial refractaria en pacientes con enfermedad renal crónicapautas de optimización del tratamiento diurético

Abstract

Resistant hypertension is associated with chronic kidney disease (CKD).There are several mechanisms involved in this association, but the mainmechanism is intravascular volume overload. Therefore, the optimizationof diuretic treatment in these patients should be the key to improve BPcontrol. We argue that in patients with CKD strategies based on the optimizationof diuretic treatment may help to better control BP and slow CKD progression.In order to confirm this hypothesis, we made several studies whose mainobjectives were:- To analyze the prevalence of resistant hypertension in a population with CKD and analyze the characteristics of these patients- To Evaluate the hydration status of patients with CKD and resistanthypertension by performing bioimpedance.- To evaluate the effect on the control of BP in patients with resistant hypertension of two therapeutic strategies based on the optimization ofdiuretic treatment: intensification diuretic vs aldosterone antagoniststreatment.- To analyze the impact of blood pressure control of the two therapeuticstrategies: intensification diuretic vs aldosterone antagonists treatment, inthe renal disease progression in a group of patients with resistant hypertension...