The Role of Arterial Hypertension in The Progression of Chronic Kidney Disease
Abstract
Chronic kidney disease (CKD) is a major medical and social problem associated with a high risk of cardiovascular complications, disability, and mortality. Arterial hypertension is one of the most important factors contributing to the onset and progression of CKD. Persistent elevation of blood pressure leads to renal microvascular damage, glomerular hypertension, nephrosclerosis, albuminuria, and progressive decline in glomerular filtration rate. At the same time, impaired renal function contributes to sodium and fluid retention, activation of the renin–angiotensin–aldosterone system, and further elevation of blood pressure. This creates a vicious pathogenetic circle that accelerates the progression of renal dysfunction. The aim of this article is to evaluate the role of arterial hypertension in the progression of chronic kidney disease and to analyze the clinical and functional indicators associated with an unfavorable prognosis. The review highlights the prognostic importance of blood pressure level, estimated glomerular filtration rate, albuminuria, cardiovascular comorbidity, and duration of hypertension in patients with CKD.