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№ 5Nephrology18 min read

Renal disorders in hypertension, treatment of hypertension and usage of diuretics in renal disease

1. Big picture

Hypertension and kidney disease form a vicious circle:

Hypertension damages renal vessels → nephron ischaemia and glomerulosclerosis → chronic kidney disease (CKD) → sodium/water retention and renin-angiotensin-aldosterone system (RAAS) activation → worse hypertension.

For the exam, think in three directions:

  1. Hypertension as a cause of kidney disease Mainly hypertensive nephrosclerosis and malignant hypertensive nephropathy.

  2. Kidney disease as a cause of hypertension Renal parenchymal disease and renovascular hypertension are major secondary causes.

  3. Treatment problem CKD patients need careful antihypertensive choice, albuminuria re

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