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Review
. 2023 Oct 31;12(21):6868.
doi: 10.3390/jcm12216868.

Management of Hypertension in Diabetic Kidney Disease

Gates B Colbert  1 , Mohamed E Elrggal  2 , Anna Gaddy  3 , Hector M Madariaga  4 , Edgar V Lerma  5
Affiliations
Review

Management of Hypertension in Diabetic Kidney Disease

Gates B Colbert et al. J Clin Med. .

Abstract

Hypertension is a critical component of cardiovascular disease progression in patients with chronic kidney disease, and specifically diabetic kidney disease (DKD). Causation versus correlation remains up for debate, but what has been confirmed is the delay of DKD progression when hypertension is controlled or moved to guideline drive ranges. Many medications have been studied and used in real world experience for best outcomes, and we discuss below the proven winners thus far making up the renin angiotensin aldosterone system. As well, we discuss guideline changing medications including sodium-glucose cotransporter 2 inhibitors and newer generation mineralocorticoid receptor antagonists. With the growing prevalence of diabetes and DKD in the population, newer agents are emerging in multiple drug class and will be highlighted below. Clinicians continue to search for the optimal care plans for this challenging patient population.

Keywords: RAASi; SGTL2i; aldosterone; hypertension; mineralocorticoid receptor antagonist.

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Conflict of interest statement

Colbert: Consultant for AstraZeneca, Bayer and CSL Vifor. Lerma: Consultant for AstraZeneca, Bayer, Boehringer Ingelheim, CSL Vifor.

Figures

Figure 1
Figure 1
Pathophysiological mechanisms of lowering blood pressure. Abbreviations: BP, blood pressure; NO. nitric oxide; SNA, sympathetic nervous. Source: Sanidas et al. [4].
See this image and copyright information in PMC

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