Hypertension in autosomal-dominant polycystic kidney disease (ADPKD)

Laia Sans-Atxer, Roser Torra, Patricia Fernández-Llama

    Research output: Contribution to journalReview articleResearchpeer-review

    10 Citations (Scopus)

    Abstract

    Cardiovascular (CV) complications are the major cause of death in autosomal-dominant polycystic kidney disease (ADPKD) patients. Hypertension is common in these patients even before the onset of renal insufficiency. Blood pressure (BP) elevation is a key factor in patient outcome, mainly owing to the high prevalence of target organ damage together with a poor renal prognosis when BP is increased. Many factors have been implicated in the pathogenesis of hypertension, including the renin-angiotensin-aldosterone system (RAAS) stimulation. Polycystin deficiency may also contribute to hypertension because of its potential role in regulating the vascular tone. Early diagnosis and treatment of hypertension improve the CV and renal complications of this population. Ambulatory BP monitoring is recommended for prompt diagnosis of hypertension. CV risk assessment is mandatory. Even though a nonpharmacological approach should not be neglected, RAAS inhibitors are the cornerstone of hypertension treatment. Calcium channel blockers (CCBs) should be avoided unless resistant hypertension is present. The BP should be <140/90 mmHg in all ADPKD patients and a more intensive control (<135/85 mmHg) should be pursued as soon as microalbuminuria or left ventricle hypertrophy is present. © 2013 © The Author 2013. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For permissions, please email: journals.permissions@oup.com.
    Original languageEnglish
    Pages (from-to)457-463
    JournalClinical Kidney Journal
    Volume6
    Issue number5
    DOIs
    Publication statusPublished - 1 Oct 2013

    Keywords

    • ambulatory blood pressure monitoring
    • blood pressure profile
    • cardiovascular risk
    • polycystic kidney disease
    • renal size

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