Blood pressure in renal disease: Objectives, surrogate markers and treatment

International Conference and Exhibition on Nephrology & Therapeutics

August 20-22, 2012 Hilton Chicago/Northbrook, USA

Nicolas Roberto Robles

Scientific Tracks Abstracts: J Nephrol Therapeut

Abstract :

D espite decades of trials, we still are uncertain as to what level we should lower BP to achieve maximal cardiovascular protection in hypertensive patients. Even more nowadays the target for reducing blood pressure in renal disease is under discussion; there is scanty evidence from randomized clinical trials to support a straight blood pressure control control but for proteinuric patients. On the other hand the value of microalbuminuria as surrogate marker of renal disease progression is controversial in hypertensive non diabetic patients. Furthermore, frequently the effects of treatment on glomerular filtration rate ? the more used and useful test for chronic kidney disease- are opposite in several clinical trials. The Avoiding Cardiovascular Events through Combination Therapy in Patients Living with Systolic Hypertension (ACCOMPLISH) trial showed that initial antihypertensive therapy with benazepril plus amlodipine was superior to benazepril plus hydrochlorothiazide in reducing progression of chronic kidney disease as well as cardiovascular morbidity and mortality in renal patients. The renal results of the ACCOMPLISH trial strongly support the recommendation of using calcium channel blockers as second antihypertensive agent added to renin-angiotensin axis blocking drugs. The validity of this data and its relationship with the cumulated evidence on the effects of calcium antagonists (especially new calcium channel blockers which reduce proteinuria) on renal disease progression will be discussed

Biography :

Dr. Nicolas completed his M.D. from Granada University and received Ph.D. Extremadura University. He worked in different disciplines and hosted different designations like Resident of Nephrology in Hospital Gregorio Marañón, Madrid. Nephrology Specialist (Universidad Complutense de Madrid), Clinical Specialist in Hipertensión (European Hypertension Society). Senior Consultant of Nephrology and Head of the Hypertension Unit of Hospital Infanta Cristina, Badajoz (Awarded by the European Hypertension Society as Excellence Center). Currently Dr. Nicolas is Associate Professor of Nephrology and Medicine (Universidad de Extremadura), Associated Director of the Cardiovascular Risk Chair, University of Salamanca School of Medicine. Vice-president of Spanish Hypertension Society (2008-2011). Author or co-author of more than two hundred scientific publications in peer-reviewed international journals and seventeen book chapters