Chronic Kidney Disease with Resistant Hypertension
Resistant hypertension is a category of severe hypertension in which blood pressure remains above target levels with the concurrent use of three antihypertensive medications,or in which at least four medications are required to control blood pressure.Among hypertension patients,its prevalence is 5％～15％,while in patients with chronic kidney disease,the prevalence of resistant hypertension is two to three times higher than that of the general population.Once diagnosed with resistant hypertension,patients with chronic kidney disease need to be treated individually according to the main pathophysiological mechanisms,but renal impairment and hyperkalemia limit the use of highly effective antihypertensive drugs such as spironolactone and increase the difficulty of treatment.Its therapeutic specificity needs to be learned together by clinicians.In this paper,we will review the epidemiology,specific pathophysiological mechanisms,diagnosis and therapeutic advances of resistant hypertension in chronic kidney disease.
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