Implications of Untreated Hypertension on Chronic Kidney Disease: A Literature Review

Main Article Content

Mustafa Abrar Zaman Kuragamage Dona Prabuddhi Thiloka Kuraga Aseel Aljeshi Aiza Kashif Jessarij Chinthamraks Hussien Abouzeid Riddhi Singh Adyan Irshad Ahmed Rayan Rezaei Tonmoy Sarker Maaz Kashif Shaan Patker Saif Bunni Jyothsnaa Sathish Simone Talreja Datta Venkata Daivik Pentapati Adhved Rajesh Krishnan Yash Mahendra Mhase

Abstract

The untreated progression of hypertension holds significant implications for the development and progression of chronic kidney disease (CKD). Therefore, necessitating the implementation of strategic hypertension management measures to mitigate its impact on chronic kidney disease. This review highlights the necessity of precise diagnostic methodologies that employ oscillometric equipment and advocates for pharmacological interventions, the incorporation of combination therapies such as the "Polypill" to effectively control hypertension, and lifestyle adjustments. The pivotal role of the renin-angiotensin-aldosterone system (RAAS) in hypertension is acknowledged, noting the importance of stringent blood pressure regulation and the utilization of RAAS-blocking agents to attenuate its association with chronic kidney disease. A comprehensive analysis is provided on the effects of various classes of antihypertensive medications on renal function, encompassing diuretics, angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), calcium channel blockers (CCBs), and nonsteroidal mineralocorticoid receptor antagonists. Additionally, both non-invasive and invasive therapeutic modalities for managing resistant hypertension in CKD patients are examined, alongside discussions on prognostic indicators and outcomes across different stages of chronic kidney disease. Lifestyle modifications such as sodium restriction, weight management, and moderation of alcohol intake are assessed for their influence on chronic kidney disease prognosis. The review also extensively delves into the impact of ethnicity on the prevalence and outcomes of hypertension-induced CKD, highlighting disparities and distinctive trends among diverse ethnic cohorts including Indian, African American, Middle Eastern, Chinese, Pacific Islander, Native American, and Hispanic populations. Additionally, this study addresses the intricate relationship between cardiovascular abnormalities and CKD, the significance of gastrointestinal disorders, and the importance of multidisciplinary approaches in CKD management. Furthermore, insights are provided into the significance of neutrophil gelatinase-associated lipocalin (NGAL) as a biomarker for identifying renal injury and chronic kidney disease progression alongside factors influencing adverse prognosis and life expectancy in CKD patients. This study accentuates the importance of tailored treatment assessments and interventions to address varied patterns and obstacles within ethnic groups, aiming to optimize chronic kidney disease management strategies and reduce health disparities.

Keywords: Hypertension, high blood pressure, chronic kidney disease, atherosclerosis, renal failure, renin-angiotensin-aldosterone system, kidney disease markers, proteinuria, end-stage renal disease

Article Details

How to Cite
ZAMAN, Mustafa Abrar et al. Implications of Untreated Hypertension on Chronic Kidney Disease: A Literature Review. Medical Research Archives, [S.l.], v. 12, n. 4, apr. 2024. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/5214>. Date accessed: 03 july 2024. doi: https://doi.org/10.18103/mra.v12i4.5214.
Section
Review Articles

References

1. Zaman MA, Awais N, Satnarine T, et al. Comparing Triple Combination Drug Therapy and Traditional Monotherapy for Better Survival in Patients With High-Risk Hypertension: A Systematic Review. Cureus. 2023;15(7). doi: 10.7759/cureus.41398

2. Carey RM, Wright JT, Taler SJ, Whelton PK. Guideline-Driven Management of Hypertension. Circ Res. 2021;128(7):827-846. doi:10.1161/ CIRCRESAHA.121.318083

3. Wald NJ, Law MR. A strategy to reduce cardiovascular disease by more than 80%. BMJ. 2003;326(7404):1419. doi:10.1136/bmj. 326.7404.1419

4. Patel S, Rauf A, Khan H, Abu-Izneid T. Renin-angiotensin-aldosterone (RAAS): The ubiquitous system for homeostasis and pathologies. Biomed Pharmacother Biomedecine Pharmacother. 2017;94:317-325. do i:10.1016 /j.biopha.2017.07.091

5. Remuzzi G, Perico N, Macia M, Ruggenenti P. The role of renin-angiotensin-aldosterone system in the progression of chronic kidney disease. Kidney Int Suppl. 2005;(99):S57-65. doi:10.1111/j.1523-1755.2005.09911.x

6. Blowey DL. Diuretics in the treatment of hypertension. Pediatr Nephrol Berl Ger. 2016; 31(12):2223-2233. doi:10.1007/s00467-016-3334-4

7. Jankowski J, Floege J, Fliser D, Böhm M, Marx N. Cardiovascular Disease in Chronic Kidney Disease. Circulation. 2021;143(11):115 7-1172. doi:10.1161/CIRCULATIONAHA.120. 050686

8. Biffi A, Dell’Oro R, Quarti-Trevano F, et al. Effects of Renal Denervation on Sympathetic Nerve Traffic and Correlates in Drug-Resistant and Uncontrolled Hypertension: A Systematic Review and Meta-Analysis. Hypertension. 2023;80(3):659-667. doi:10.1161/HYPERTENSIONAHA.122.20503

9. Tonelli M, Wiebe N, James MT, et al. A population-based cohort study defines prognoses in severe chronic kidney disease. Kidney Int. 2018;93(5):1217-1226. doi:10.101 6/j.kint.2017.12.013

10. Anchala R, Kannuri NK, Pant H, et al. Hypertension in India: a systematic review and meta-analysis of prevalence, awareness, and control of hypertension. J Hypertens. 2014;32 (6):1170.doi:10.1097/HJH.0000000000000146

11. McMahon EJ, Campbell KL, Bauer JD, Mudge DW. Altered dietary salt intake for people with chronic kidney disease. Cochrane Database Syst Rev. 2015;(2). doi:10.1002/146 51858.CD010070.pub2

12. Ravera M, Re M, Deferrari L, Vettoretti S, Deferrari G. Importance of Blood Pressure Control in Chronic Kidney Disease. J Am Soc Nephrol. 2006;17(4_suppl_2):S98. doi:10.168 1/ASN.2005121319

13. Tadic M, Cuspidi C, Hering D. Hypertension and cognitive dysfunction in elderly: blood pressure management for this global burden. BMC Cardiovasc Disord. 2016; 16(1):208. doi:10.1186/s12872-016-0386-0

14. Rahimi K, Emdin CA, MacMahon S. The Epidemiology of Blood Pressure and Its Worldwide Management. Circ Res. 2015;116( 6):925-936. doi:10.1161/CIRCRESAHA.116.304723

15. Arroyo JP, Ronzaud C, Lagnaz D, Staub O, Gamba G. Aldosterone Paradox: Differential Regulation of Ion Transport in Distal Nephron. Physiology. 2011;26(2):115-123. doi:10.1152/physiol.00049.2010

16. Kumar U, Wettersten N, Garimella PS. Cardiorenal Syndrome: Pathophysiology. Cardiol Clin. 2019;37(3):251-265. doi:10.1016 /j.ccl.2019.04.001

17. Elshafei A, Khidr EG, El-Husseiny AA, Gomaa MH. RAAS, ACE2 and COVID-19; a mechanistic review. Saudi J Biol Sci. 2021;28( 11):6465-6470. doi:10.1016/j.sjbs.2021.07.003

18. Ma TK, Kam KK, Yan BP, Lam YY. Renin–angiotensin–aldosterone system blockade for cardiovascular diseases: current status. Br J Pharmacol. 2010;160(6):1273-1292. doi:10.11 11/j.1476-5381.2010.00750.x

19. Ameer OZ. Hypertension in chronic kidney disease: What lies behind the scene. Front Pharmacol. 2022;13. doi:10.3389/fphar. 2022.949260

20. Zamboli P, De Nicola L, Minutolo R, et al. Effect of furosemide on left ventricular mass in non-dialysis chronic kidney disease patients: a randomized controlled trial. Nephrol Dial Transplant. 2011;26(5):1575-1583. doi:10.109 3/ndt/gfq565

21. Casas JP, Chua W, Loukogeorgakis S, et al. Effect of inhibitors of the renin-angiotensin system and other antihypertensive drugs on renal outcomes: systematic review and meta-analysis. Lancet Lond Engl. 2005;366(9502):2 026-2033. doi:10.1016/s0140-6736(05)67814-2

22. Ptinopoulou AG, Pikilidou MI, Lasaridis AN. The effect of antihypertensive drugs on chronic kidney disease: a comprehensive review. Hypertens Res Off J Jpn Soc Hypertens. 2013;36(2):91-101. doi:10.1038/hr .2012.157

23. Ohno S, Ishii A, Yanagita M, Yokoi H. Calcium channel blocker in patients with chronic kidney disease. Clin Exp Nephrol. 2022;26(3):207-215. doi:10.1007/s10157-021 -02153-1

24. Lerma E, White WB, Bakris G. Effectiveness of nonsteroidal mineralocorticoid receptor antagonists in patients with diabetic kidney disease. Postgrad Med. 2023;135(3):2 24-233.doi:10.1080/00325481.2022.2060598

25. Vargas F, Romecín P, García-Guillén AI, et al. Flavonoids in Kidney Health and Disease. Front Physiol. 2018;9:394. doi:10.3389/fphys. 2018.00394

26. Gao Q, Tan NC, Lee ML, Hsu W, Choo J. Comparative effectiveness of first-line antihypertensive drug classes on the maintenance of estimated glomerular filtration rate (eGFR) in real world primary care. Sci Rep. 2023;13(1):21225. doi:10.1038/ s41598-023-48427-4

27. Sinha AD, Agarwal R. Clinical Pharmacology of Antihypertensive Therapy for the Treatment of Hypertension in CKD. Clin J Am Soc Nephrol CJASN. 2019;14(5):75 7-764. doi:10.2215/CJN.04330418

28. Molnar MZ, Kalantar-Zadeh K, Lott EH, et al. Angiotensin-converting enzyme inhibitor, angiotensin receptor blocker use, and mortality in patients with chronic kidney disease. J Am Coll Cardiol. 2014;63(7):650-658. doi:10.1016/j.jacc.2013.10.050

29. Pugh D, Gallacher PJ, Dhaun N. Management of Hypertension in Chronic Kidney Disease. Drugs. 2019;79(4):365-379. doi:10.1007/s40265-019-1064-1

30. Delrue C, Speeckaert MM. Chronic Kidney Disease: Early Detection, Mechanisms, and Therapeutic Implications. J Pers Med. 2023;13(10):1447. doi:10.3390/jpm13101447

31. Hakeem A, Bhatti S, Trevino AR, Samad Z, Chang SM. Non-invasive risk assessment in patients with chronic kidney disease. J Nucl Cardiol. 2011;18(3):472-485. doi:10.1007/s12 350-011-9359-y

32. Joo YS, Rim TH, Koh HB, et al. Non-invasive chronic kidney disease risk stratification tool derived from retina-based deep learning and clinical factors. Npj Digit Med. 2023;6(1):1-7. doi:10.1038/s41746-023-00860-5

33. Reddy YNV, Obokata M, Dean PG, Melenovsky V, Nath KA, Borlaug BA. Long-term cardiovascular changes following creation of arteriovenous fistula in patients with end stage renal disease. Eur Heart J. 2017;38(24):1913-1923. doi:10.1093/eurheartj/ehx045

34. Fay KS, Cohen DL. Resistant Hypertension in People With CKD: A Review. Am J Kidney Dis Off J Natl Kidney Found. 2021;77(1):110-121. doi:10.1053/j.ajkd.2020.04.017

35. Sanders MF, Blankestijn PJ. Chronic Kidney Disease As a Potential Indication for Renal Denervation. Front Physiol. 2016;7:220. doi:10.3389/fphys.2016.00220

36. Aldiabat M, Alabdallah K, Kofahi A, Aziz S. Bilateral Nephrectomy, the Forgotten Measure in the Treatment of Refractory Hypertension in Patients With End-Stage Renal Disease: A Case Report and Literature Review. Cureus. 2020;12(7):e9031. doi:10.775 9/cureus.9031

37. Rey-García J, Townsend RR. Renal Denervation: A Review. Am J Kidney Dis Off J Natl Kidney Found. 2022;80(4):527-535. doi:1 0.1053/j.ajkd.2022.03.015

38. Gajulapalli RD, Chahine J, Rader F, Aneja A. Procedures and devices to treat resistant hypertension in chronic kidney disease. Cleve Clin J Med. 2020;87(7):435-443. doi:10.3949/ ccjm.87a.19099

39. van Rijn MHC, van de Luijtgaarden M, van Zuilen AD, et al. Prognostic models for chronic kidney disease: a systematic review and external validation. Nephrol Dial Transplant Off Publ Eur Dial Transpl Assoc - Eur Ren Assoc. 2021;3 6(10):1837-1850. doi:10.1093/n dt/gfaa155

40. Bian Z, Zhang Q, Shen L, Chen S. The influence of multidisciplinary team clinic on the prognosis of patients with chronic kidney disease. Exp Biol Med. 2022;247(10):815-821. doi:10.1177/15353702221077937

41. Wang J, Lv J, He K, et al. Longitudinal Follow-Up and Outcomes for Chinese Patients with Stage 1–4 Chronic Kidney Disease. Kidney Dis. 2021;8(1):72-81. doi:10.1159/000 519190

42. Neild GH. Life expectancy with chronic kidney disease: an educational review. Pediatr Nephrol. 2017;32(2):243-248. doi:10.1007/s0 0467-016-3383-8

43. Chen SC, Huang JC, Su HM, et al. Prognostic Cardiovascular Markers in Chronic Kidney Disease. Kidney Blood Press Res. 2018;43(4):1388-1407. doi:10.1159/000492953

44. Basturk T, Sari O, Koc Y, et al. Prognostic significance of NGAL in early stage chronic kidney disease. Minerva Urol E Nefrol Ital J Urol Nephrol. 2017;69(3):307-312. doi:10.237 36/S0393-2249.16.02770-3

45. Valdez Ortiz R, Escorza-Valdivia S, Benitez-Renteria S, Lopez-Alvarenga JC, Pérez-Navarro LM. Factors of Poor Prognosis Associated with Chronic Kidney Disease by Stage in Ambulatory Patients: A Cross-sectional Study. Arch Med Res. 2022;53(5):52 4-532. doi:10.1016/j.arcmed.2022.06.005

46. Valdivielso JM, Rodríguez-Puyol D, Pascual J, et al. Atherosclerosis in Chronic Kidney Disease: More, Less, or Just Different? Arterioscler Thromb Vasc Biol. 2019;39(10):19 38-1966. doi:10.1161/ATVBAHA.119.312705

47. Costa-Moreira P, Vilas-Boas F, Teixeira Fraga A, Macedo G. Particular aspects of gastroenterological disorders in chronic kidney disease and end-stage renal disease patients: a clinically focused review. Scand J Gastroenterol. 2020;55(2):129-138. doi:10.10 80/00365521.2020.1722217

48. Slagman MCJ, Waanders F, Hemmelder MH, et al. Moderate dietary sodium restriction added to angiotensin converting enzyme inhibition compared with dual blockade in lowering proteinuria and blood pressure: randomised controlled trial. BMJ. 2011;343:d 4366. doi:10.1136/bmj.d4366

49. Vogt L, Waanders F, Boomsma F, de Zeeuw D, Navis G. Effects of Dietary Sodium and Hydrochlorothiazide on the Antiproteinuric Efficacy of Losartan. J Am Soc Nephrol. 2008; 19(5):999. doi:10.1681/ASN.2007060693

50. Guild SJ, McBryde FD, Malpas SC, Barrett CJ. High dietary salt and angiotensin II chronically increase renal sympathetic nerve activity: a direct telemetric study. Hypertens Dallas Tex 1979. 2012;59(3):614-620. doi:10.1 161/HYPERTENSIONAHA.111.180885

51. Navaneethan SD, Yehnert H, Moustarah F, Schreiber MJ, Schauer PR, Beddhu S. Weight Loss Interventions in Chronic Kidney Disease: A Systematic Review and Meta-analysis. Clin J Am Soc Nephrol. 2009;4(10):1 565. doi:10.2215/CJN.02250409

52. Morales E, Valero MA, León M, Hernández E, Praga M. Beneficial effects of weight loss in overweight patients with chronic proteinuric nephropathies. Am J Kidney Dis Off J Natl Kidney Found. 2003;41( 2):319-327. doi:10.1053/ajkd.2003.50039

53. Wahba IM, Mak RH. Obesity and Obesity-Initiated Metabolic Syndrome: Mechanistic Links to Chronic Kidney Disease. Clin J Am Soc Nephrol. 2007;2(3):550. doi:10.2215/CJN .04071206

54. Barcellos FC, Del Vecchio FB, Reges A, et al. Exercise in patients with hypertension and chronic kidney disease: a randomized controlled trial. J Hum Hypertens. 2018;32(6): 397-407. doi:10.1038/s41371-018-0055-0

55. Joo YS, Koh H, Nam KH, et al. Alcohol Consumption and Progression of Chronic Kidney Disease: Results From the Korean Cohort Study for Outcome in Patients with Chronic Kidney Disease. Mayo Clin Proc. 2020;95(2):293-305. doi:10.1016/j.mayocp.2019.06.014

56. Staplin N, Haynes R, Herrington WG, et al. Smoking and Adverse Outcomes in Patients With CKD: The Study of Heart and Renal Protection (SHARP). Am J Kidney Dis Off J Natl Kidney Found. 2016;68(3):371-380. doi:10.1053/j.ajkd.2016.02.052

57. Bundy JD, Bazzano LA, Xie D, et al. Self-Reported Tobacco, Alcohol, and Illicit Drug Use and Progression of Chronic Kidney Disease. Clin J Am Soc Nephrol. 2018;13(7):9 93. doi:10.2215/CJN.11121017

58. Okati-Aliabad H, Ansari-Moghaddam A, Kargar S, Mohammadi M. Prevalence of hypertension and pre-hypertension in the Middle East region: a systematic review & meta-analysis. J Hum Hypertens. 2022;36(9):7 94-804. doi:10.1038/s41371-021-00647-9

59. Laster M, Shen JI, Norris KC. Kidney Disease Among African Americans: A Population Perspective. Am J Kidney Dis Off J Natl Kidney Found. 2018;72(5 Suppl 1):S3-S7. doi:10.1053/j.ajkd.2018.06.021

60. Hounkpatin HO, Fraser SDS, Honney R, Dreyer G, Brettle A, Roderick PJ. Ethnic minority disparities in progression and mortality of pre-dialysis chronic kidney disease: a systematic scoping review. BMC Nephrol. 2020;21(1):217. doi:10.1186/s12882-020-01852-3

61. Bour SJ, Schachter M, Er L, Djurdjev O, Levin A. A systematic review of ethnic differences in the rate of renal progression in CKD patients. Nephrol Dial Transplant. 2010; 25(8):2422-2430. doi:10.1093/ndt/gfq283

62. Xu R, Zhang L, Zhang P, Wang F, Zuo L, Wang H. Comparison of the prevalence of chronic kidney disease among different ethnicities: Beijing CKD survey and American NHANES. Nephrol Dial Transplant. 2009;24(4) :1220-1226. doi:10.1093/ndt/gfn609

63. Thomas IC, Allison MA. Hypertension in Hispanics/ Latinos: Epidemiology and Considerations for Management. Curr Hypertens Rep. 2019;21(6):43. doi:10.1007/s11906-019-0947-6

64. Horowitz B, Miskulin D, Zager P. Epidemiology of hypertension in CKD. Adv Chronic Kidney Dis. 2015;22(2):88-95. doi:10.1053/j.ackd.2014.09.004