ABSTRACT
Chronic kidney disease (CKD) is a worldwide public health problem affecting more than 10% of adults in developed societies, while its incidence rate is around 0.2% in the general population. The most common comorbidity accompanying CKD is hypertension, whereas its prevalence in general population is remarkably lower. Complications unique to CKD, such as secondary hyperparathyroidism and increased calcium-phosphate products leading to elevated arterial stiffness, or increased prevalence of sleep apnoea, as well as use of specific drugs such erythropoietin, steroids or calcineurin inhibitors may also be involved. The scarcity of effective means to halt the progression of proteinuric CKD led to several research efforts to evaluate the effects of aggressive receptor antagonists blockade. As most patients with CKD and proteinuria would need a combination of two or more antihypertensive agents to reach the aforementioned blood pressure goals, and renal function deterioration is accompanied with salt and water retention, diuretics are usually necessary in patients with CKD.
