Diabetic Kidney Disease and Hypertension

Abstract

Achieving blood pressure (BP) goals is an essential goal for both primary and secondary prevention of diabetic kidney disease (DKD). Even though there is universal agreement about the importance of controlling BP, there are many issues about many aspects of hypertension management for DKD patients. These issues include: what is the optimal BP for the prevention or slowing of progression of DKD patients; what is the best method for diagnosing hypertension and monitoring BP, and what are the best medicines to use to treat hypertension in DKD patients. In this review, these issues as well as others will be discussed.

Key words

diabetic nephropathy - hypertension - RAAS inhibition

• References

• 1 Van Buren PN, Toto R. Hypertension in diabetic nephropathy: epidemiology, mechanisms, and management. Adv Chronic Kidney Dis 2011; 18: 28-41
• 2 Rosendorff C, Lackland DT, Allison M et al. Treatment of hypertension in patients with coronary artery disease: a scientific statement from the american heart association, american college of cardiology, and american society of hypertension. Circulation 2015; 131: e435-e470
• 3 Ninomiya T, Perkovic V, de Galan BE et al. Albuminuria and kidney function independently predict cardiovascular and renal outcomes in diabetes. J Am Soc Nephrol 2009; 20: 1813-1821
• 4 Afkarian M, Sachs MC, Kestenbaum B et al. Kidney disease and increased mortality risk in type 2 diabetes. J Am Soc Nephrol 2013; 24: 302-308
• 5 James PA, Oparil S, Carter BL et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA 2014; 311: 507-520
• 6 Professional Practice Committee . Standards of medical care in diabetes – 2015: summary of revisions. Diabetes Care 2015; 38 Suppl S4
• 7 Kidney Disease/Improving Global Outcomes . KDIGO Clinical Practice Guideline for the Management of Blood Pressure in Chronic Kidney Disease. Kidney International 2012; 38: 340-414
• 8 ACCORD Study Group . Cushman WC, Evans GW et al. Effects of intensive blood-pressure control in type 2 diabetes mellitus. The New England journal of medicine 2010; 362: 1575-1585
• 9 Cooper-DeHoff RM, Gong Y, Handberg EM et al. Tight blood pressure control and cardiovascular outcomes among hypertensive patients with diabetes and coronary artery disease. JAMA 2010; 304: 61-68
• 10 de Boer IH, Rue TC, Hall YN et al. Temporal trends in the prevalence of diabetic kidney disease in the United States. JAMA 2011; 305: 2532-2539
• 11 Niewczas MA, Gohda T, Skupien J et al. Circulating TNF receptors 1 and 2 predict ESRD in type 2 diabetes. J Am Soc Nephrol 2012; 23: 507-515
• 12 Sabbisetti VS, Waikar SS, Antoine DJ et al. Blood kidney injury molecule-1 is a biomarker of acute and chronic kidney injury and predicts progression to ESRD in type I diabetes. J Am Soc Nephrol 2014; 25: 2177-2186
• 13 Klahr S, Levey AS, Beck GJ et al. The effects of dietary protein restriction and blood-pressure control on the progression of chronic renal disease. Modification of Diet in Renal Disease Study Group. The New England journal of medicine 1994; 330: 877-884
• 14 Ruggenenti P, Perna A, Loriga G et al. Blood-pressure control for renoprotection in patients with non-diabetic chronic renal disease (REIN-2): multicentre, randomised controlled trial. Lancet 2005; 365: 939-946
• 15 Wright Jr JT, Bakris G, Greene T et al. Effect of blood pressure lowering and antihypertensive drug class on progression of hypertensive kidney disease: results from the AASK trial. JAMA 2002; 288: 2421-2431
• 16 Bakris GL, Weir MR, Shanifar S et al. Effects of blood pressure level on progression of diabetic nephropathy: results from the RENAAL study. Archives of internal medicine 2003; 163: 1555-1565
• 17 Berl T, Hunsicker LG, Lewis JB et al. Impact of achieved blood pressure on cardiovascular outcomes in the Irbesartan Diabetic Nephropathy Trial. J Am Soc Nephrol 2005; 16: 2170-2179
• 18 Lv J, Neal B, Ehteshami P et al. Effects of intensive blood pressure lowering on cardiovascular and renal outcomes: a systematic review and meta-analysis. PLoS Med 2012; 9: e1001293
• 19 Tamura K, Azushima K, Umemura S. Day-by-day home-measured blood pressure variability: another important factor in hypertension with diabetic nephropathy?. Hypertens Res 2011; 34: 1249-1250
• 20 de la Sierra A, Segura J, Gorostidi M et al. Diurnal blood pressure variation, risk categories and antihypertensive treatment. Hypertens Res 2010; 33: 767-771
• 21 Ushigome E, Fukui M, Hamaguchi M et al. The coefficient variation of home blood pressure is a novel factor associated with macroalbuminuria in type 2 diabetes mellitus. Hypertens Res 2011; 34: 1271-1275
• 22 Stergiou GS, Nasothimiou EG. Home monitoring is the optimal method for assessing blood pressure variability. Hypertens Res 2011; 34: 1246-1248
• 23 Kamoi K. Usefulness of morning home blood pressure measurements in patients with type 2 diabetes mellitus: results of a 10-year, prospective, longitudinal study. Clin Exp Hypertens 2015; 37: 122-127
• 24 Sharman JE, Howes FS, Head GA et al. Home blood pressure monitoring: Australian expert consensus statement. J Hypertens 2015;
• 25 Lim HS, MacFadyen RJ, Lip GY. Diabetes mellitus, the renin-angiotensin-aldosterone system, and the heart. Archives of internal medicine 2004; 164: 1737-1748
• 26 Lewis EJ, Hunsicker LG, Bain RP et al. The effect of angiotensin-converting-enzyme inhibition on diabetic nephropathy. The Collaborative Study Group. The New England journal of medicine 1993; 329: 1456-1462
• 27 Palmer SC, Mavridis D, Navarese E et al. Comparative efficacy and safety of blood pressure-lowering agents in adults with diabetes and kidney disease: a network meta-analysis. Lancet 2015; 385: 2047-2056
• 28 Lv J, Perkovic V, Foote CV et al. Antihypertensive agents for preventing diabetic kidney disease. Cochrane Database Syst Rev 2012; 12: CD004136
• 29 Roshan B, Stanton RC. A story of microalbuminuria and diabetic nephropathy. J Nephropathol 2013; 2: 234-240
• 30 National Kidney F . KDOQI Clinical Practice Guideline for Diabetes and CKD: 2012 Update. Am J Kidney Dis 2012; 60: 850-886
• 31 Mauer M, Zinman B, Gardiner R et al. Renal and retinal effects of enalapril and losartan in type 1 diabetes. The New England journal of medicine 2009; 361: 40-51
• 32 Investigators O . Yusuf S, Teo KK et al. Telmisartan, ramipril, or both in patients at high risk for vascular events. The New England journal of medicine 2008; 358: 1547-1559
• 33 Fried LF, Emanuele N, Zhang JH et al. Combined angiotensin inhibition for the treatment of diabetic nephropathy. The New England journal of medicine 2013; 369: 1892-1903
• 34 Tobe SW, Clase CM, Gao P et al. Cardiovascular and renal outcomes with telmisartan, ramipril, or both in people at high renal risk: results from the ONTARGET and TRANSCEND studies. Circulation 2011; 123: 1098-1107
• 35 Chawla LS, Kimmel PL. Acute kidney injury and chronic kidney disease: an integrated clinical syndrome. Kidney Int 2012; 82: 516-524
• 36 Gentile G, Remuzzi G, Ruggenenti P. Dual renin-angiotensin system blockade for nephroprotection: still under scrutiny. Nephron 2015; 129: 39-41
• 37 Parving HH, Brenner BM, McMurray JJ et al. Cardiorenal end points in a trial of aliskiren for type 2 diabetes. The New England journal of medicine 2012; 367: 2204-2213
• 38 Mehdi UF, Adams-Huet B, Raskin P et al. Addition of angiotensin receptor blockade or mineralocorticoid antagonism to maximal angiotensin-converting enzyme inhibition in diabetic nephropathy. J Am Soc Nephrol 2009; 20: 2641-2650
• 39 Adrogue HJ, Madias NE. The impact of sodium and potassium on hypertension risk. Semin Nephrol 2014; 34: 257-272
• 40 Lambers-Heerspink HJ, Holtkamp FA, Parving HH et al. Moderation of dietary sodium potentiates the renal and cardiovascular protective effects of angiotensin receptor blockers. Kidney Int 2012; 82: 330-337
• 41 Kwakernaak AJ, Krikken JA, Binnenmars SH et al. Effects of sodium restriction and hydrochlorothiazide on RAAS blockade efficacy in diabetic nephropathy: a randomised clinical trial. Lancet Diabetes Endocrinol 2014; 2: 385-395
• 42 Sacks FM, Obarzanek E, Windhauser MM et al. Rationale and design of the Dietary Approaches to Stop Hypertension trial (DASH). A multicenter controlled-feeding study of dietary patterns to lower blood pressure. Ann Epidemiol 1995; 5: 108-118
• 43 Estruch R, Ros E, Salas-Salvado J et al. Primary prevention of cardiovascular disease with a Mediterranean diet. The New England journal of medicine 2013; 368: 1279-1290
• 44 Otoda T, Kanasaki K, Koya D. Low-protein diet for diabetic nephropathy. Curr Diab Rep 2014; 14: 523
• 45 Umpierrez GE, Cantey P, Smiley D et al. Primary aldosteronism in diabetic subjects with resistant hypertension. Diabetes Care 2007; 30: 1699-1703
• 46 Reincke M, Meisinger C, Holle R et al. Is primary aldosteronism associated with diabetes mellitus? Results of the German Conn’s Registry. Horm Metab Res 2010; 42: 435-439
• 47 Postma CT, Klappe EM, Dekker HM et al. The prevalence of renal artery stenosis among patients with diabetes mellitus. Eur J Intern Med 2012; 23: 639-642
• 48 ASTRAL Investigators . Wheatley K, Ives N et al. Revascularization versus medical therapy for renal-artery stenosis. The New England journal of medicine 2009; 361: 1953-1962