| [ Summary ] |
MDRD study showed that in chronic renal failure, strict control of blood pressure reduced urinary protein excretion and slowed the rate of glomerular filtration rate decline. In addition, recent clinical studies such as AIPRI, REIN, ESPIRAL, RENALL and IDNT indicated that angiotensin-converting enzyme inhibitors (ACEI) and angiotensin type 1 receptor blockers (ARB) had specific renoprotective effects independent of the blood pressure lowering effects of the drugs. Based on these recent advances, it is recommended that in cases of chronic renal failure that target blood pressure be kept under 130 / 80 mmHg and that ACEI or ARB should be used as first line antihypertensive drugs. When the target blood pressure can not be obtained with ACEI or ARB alone, Ca antagonists or diuretics should be added for sufficient control of blood pressure and for retardation of GFR decline in cases of chronic renal failure. |