Kumagai Hiroo, Hyodo Toshitake, Kushiyama Taketoshi, Higashi Keishi, Yamamoto Kojiro
Department of Nephrology, National Defense Medical College.
Nihon Rinsho. 2008 Aug;66(8):1574-81.
The aims of treating hypertension in patients with chronic kidney disease including diabetes are to prevent both cardiovascular events and end stage renal failure, and goal of blood pressure is less than 130/80 mmHg. The first choice is angiotensin II receptor blocker (ARB) or angiotensin converting enzyme inhibitor. If the patient is salt-sensitive and hypervolemic, the second choice is diuretic. When the patient has some risk factors for cardiovascular events, the second choice is calcium channel blocker. In treating patient whose serum creatinine more than 2 mg/dL, we should start the ARB with lower dose and examine serum creatinine and potassium every 2 week.