Management of Hypertension in Diabetic Kidney Disease

• Published in: Journal of clinical medicine Vol. 12; no. 21; p. 6868
• Main Authors: Colbert, Gates B, Elrggal, Mohamed E, Gaddy, Anna, Madariaga, Hector M, Lerma, Edgar V
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 31.10.2023
• Subjects: Blood pressure; Care and treatment; Clinical medicine; Clinical trials; Complications and side effects; Creatinine; Diabetes; Diabetic nephropathies; Diabetic nephropathy; Drug dosages; Drug therapy; Enzymes; Heart attacks; Heart failure; Hemodialysis; Hyperkalemia; Hypertension; Hypotension; Kidney diseases; Mortality; Potassium; United States; SGTL2i; RAASi; mineralocorticoid receptor antagonist; hypertension; aldosterone
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm12216868

Hypertension is a critical component of cardiovascular disease progression in patients with chronic kidney disease, and specifically diabetic kidney disease (DKD). Causation versus correlation remains up for debate, but what has been confirmed is the delay of DKD progression when hypertension is controlled or moved to guideline drive ranges. Many medications have been studied and used in real world experience for best outcomes, and we discuss below the proven winners thus far making up the renin angiotensin aldosterone system. As well, we discuss guideline changing medications including sodium-glucose cotransporter 2 inhibitors and newer generation mineralocorticoid receptor antagonists. With the growing prevalence of diabetes and DKD in the population, newer agents are emerging in multiple drug class and will be highlighted below. Clinicians continue to search for the optimal care plans for this challenging patient population.