日本医科大学医学会雑誌
Online ISSN : 1880-2877
Print ISSN : 1349-8975
ISSN-L : 1349-8975
臨床医のために
慢性腎臓病合併例の高血圧治療
内海 甲一平間 章郎上田 佳恵三井 亜希子金子 朋広飯野 靖彦片山 泰朗
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2010 年 6 巻 1 号 p. 17-22

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Chronic kidney disease (CKD) is defined by two criteria. One criterion is abnormal renal function or morphology, especially proteinuria. A second criterion is an estimated glomerular filtration rate (eGFR) less than 60 mL/min/1.73m2 calculated with the serum creatinine concentration. CKD is classified on the basis of eGFR from stage 1 to stage 5. CKD is a common cause of cardiovascular disease (CVD). CVD is a major cause of morbidity and mortality in patients with CKD. Management of hypertension in patients with CKD aims to prevent CVD and provide renoprotection. First-line agents for controlling blood pressure are inhibitors of the renin-angiotensin system: angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers. These agents are superior to other classes of antihypertensive agents in reducing the amount of urinary protein and in preserving renal function. In CKD, the target blood pressure is less than 130/80mmHg, and 125/75mmHg, if the amount of urinary protein is more than 1g/day. To achieve the target blood pressure, other classes of antihypertensive agents, such as diuretics and calcium channel blockers, should also be administered.

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© 2010 日本医科大学医学会
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