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Kronik Böbrek Hastalığında Antihipertansif Tedavi İlkeleri

Principles of Antihypertensive Therapy in Chronic Kidney Disease

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Abstract (2. Language): 
Numerous studies have documented the high risk of cardiovascular disease (CVD) in patients with chronic kidney disease (CKD). There are several reasons for the high risk of CVD—in particular the older age of patients, the higher prevalence of tradition¬al CVD risk factors (such as hypertension, diabetes and hyperlipi-demia), and the presence of CKD-related risk factors such as coro¬nary calcifications from an elevated calcium-phosphorous product. A multidisciplinary strategy is necessary to reduce the risk of CVD in this patient population, and hypertension is only one of the therapeutic areas: The goals of antihypertensive therapy in CKD patients are to lower blood pressure, reduce the risk of CVD, and slow progression of CKD. ACE inhibitors and ARBs are recom¬mended for patients with diabetic kidney diseases and nondiabet-ic kidney diseases with proteinuria. In these patients, these agents lower blood pressure, reduce proteinuria, slow the progression of kidney disease, and likely reduce CVD risk.
Abstract (Original Language): 
Çeşitli çalışmalar kronik böbrek hastalığında (KBH) yüksek kar-diyovasküler hastalık (KVH) riskini belirlemiştir. ileri yaş, hipertan¬siyon, diyabet, hiperlipidemi gibi geleneksel risk faktörlerinin yük¬sek prevalansının yanında kalsiyum-fosfor (Ka-F) çarpımına bağlı koroner kalsifikasyon gibi KBH ile ilişkili risk faktörleri yüksek KVH riskini oluşturan çeşitli nedenlerdir. Bu toplulukta KVH riskini azaltmak için multidisipliner stratejiler gereklidir ve hipertansiyon tera-pötik alanların sadece biridir. KBH'de antihipertansif tedavinin amacı kan basıncını düşürmek, KVH riskini azaltmak ve KBH'nin ilerlemesini yavaşlatmaktır. Diyabetik ve diyabetik olmayan prote-inürili böbrek hastalarında ACE inhibitörleri ve ARB'ler önerilmektedir. Bu hastalarda bu ilaçlar kan basıncını düşürür, proteinüriyi azaltır, böbrek hastalığının ilerlemesini yavaşlatır ve KVH riskini azaltırlar.
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