Nephrology

Hypertension

Questions discussed in this category

Would you treat an ESKD patient with renal artery stenosis in an attempt to improve blood pressure control and preserve residual renal function?

2 Answers available

What are your top takeaways from ASN 2024?

1 Answer available

Do you prefer using losartan in your patients with hypertension and gout due to its uricosuric effects?

2 Answers available

How do the results of the ESPRIT trial, which evaluated the impact of an SBP target of <120 mmHg on preventing major cardiovascular events, influence your blood pressure management goals for hypertensive patients with diabetes or a history of stroke?

ESPRIT Trial

1 Answer available

How do you approach long-term blood pressure parameters in ischemic stroke patients with severe symptomatic intracranial stenosis?

How do you balance between having a higher long-term blood pressure to prevent flow failure and leading to worsening of stenosis or occlusion from the...

2 Answers available

What is your approach to initiating spironolactone in patients with end stage kidney disease and heart failure?

4 Answers available

How does contralateral suppression of more than 50% with cosyntropin during adrenal venous sampling influence your decision to recommend adrenalectomy in patients with primary aldosteronism?

Okubo et al., PMID 38442744

1 Answer available

Can a dihydropyridine calcium channel blocker (CCB) like amlodipine be prescribed in addition to a non-dihydropyridine CCB such as diltiazem or verapamil for treating hypertension?

2 Answers available

Do you prefer telmisartan over other ARBs given its longer half life elimination?

2 Answers available

What is your preferred initial imaging choice for a patient suspected of having renal artery stenosis who does not have any contraindications to imaging contrast media?

1 Answer available

In patients with hypertension and suspected primary aldosteronism who have undergone negative confirmatory testing, what follow-up and monitoring strategies would you recommend to ensure early detection of potential aldosteronism?

1 Answer available

Do you recommend taking any unique approaches to managing patients with persistent hypertension following bilateral renal artery stenting?

1 Answer available

Under what circumstances do you recommend targeting a systolic blood pressure of less than 120 mmHg in a patient with CKD?

2 Answers available

Do you recommend bedtime administration of antihypertensives in patients who exhibit nondipping on ambulatory blood pressure monitoring?

3 Answers available

What is the optimal approach to treat isolated diastolic hypertension?

1 Answer available

Do you recommend increasing dietary potassium intake for blood pressure management in non-CKD patients with hypertension?

1 Answer available

What is the approach to use of ACE inhibitors for suspected scleroderma renal crisis in patients with only mildly elevated BP and renal artery stenosis?

2 Answers available

What is your approach to managing patients with labile blood pressures secondary to baroreflex failure?

1 Answer available

What are your top takeaways from ASN 2023?

2 Answers available

Do you recommend performing cognitive testing in the clinic to determine the blood pressure target in patients 80 years or older?

1 Answer available

Are there instances when you would recommend against pursuing adrenal vein sampling in a patient with primary hyperaldosteronism and normal adrenal imaging?

1 Answer available

What is your approach to thiazide diuretic use in those with uncontrolled hypertension and advanced chronic kidney disease?

2 Answers available

What is a reasonable blood pressure goal for refractory HTN in the geriatric population?

1 Answer available

Which medications do you deem necessary to stop prior to measuring plasma renin and plasma aldosterone when evaluating a patient for possible primary aldosteronism?

1 Answer available

What is the next best anti-hypertensive medication to start after mineralocorticoid receptor antagonists in patients with primary aldosteronism?

1 Answer available

Is there a role for vascular intervention in patients with renal artery stenosis found during work up of resistant hypertension?

1 Answer available

Do you recommend using doses of ACEi or ARBs that is above the usual dosing with the goal of reducing a patient's proteinuria further?

1 Answer available

What is your preferred method for confirming the diagnosis of primary aldosteronism in a patient with an elevated plasma aldosterone to renin ratio?

1 Answer available

Do you recommend switching to a non-dihydropyridine calcium channel blocker with the goal of decreasing proteinuria in a proteinuric, hypertensive CKD patient already on a dihydropyridine calcium channel blocker?

1 Answer available

For which patients do you prioritize ambulatory blood pressure monitoring over self-measured blood pressure?

1 Answer available

How do you estimate daily dietary sodium intake in your patients with hypertension?

1 Answer available

Papers discussed in this category

JAMA, 2016-06-28

Intensive vs Standard Blood Pressure Control and Cardiovascular Disease Outcomes in Adults Aged ≥75 Years: A Randomized Clinical Trial.

JAMA, 2019-02-12

Effect of Intensive vs Standard Blood Pressure Control on Probable Dementia: A Randomized Clinical Trial.

The Journal of clinical endocrinology and metabolism, 2016-05

The Management of Primary Aldosteronism: Case Detection, Diagnosis, and Treatment: An Endocrine Society Clinical Practice Guideline.

Hypertension (Dallas, Tex. : 1979), 2017 Nov 13

2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.

The New England journal of medicine, 2021 Nov 05

Chlorthalidone for Hypertension in Advanced Chronic Kidney Disease.

JAMA, 2019-08-13

Association of Intensive vs Standard Blood Pressure Control With Cerebral White Matter Lesions.

The New England journal of medicine, 2014-01-02

Stenting and medical therapy for atherosclerotic renal-artery stenosis.

Annals of internal medicine, 2009 May 04

Stent placement in patients with atherosclerotic renal artery stenosis and impaired renal function: a randomized trial.

The New England journal of medicine, 2009 Nov 12

Revascularization versus medical therapy for renal-artery stenosis.

Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2015-01

Liver involvement in early autosomal-dominant polycystic kidney disease.

N Engl J Med, 2015 Nov 09

A Randomized Trial of Intensive versus Standard Blood-Pressure Control.

Lancet (London, England), 2005 Mar 12-18

Blood-pressure control for renoprotection in patients with non-diabetic chronic renal disease (REIN-2): multicentre, randomised controlled trial.

Kidney international, 2019-04

Safety and cardiovascular efficacy of spironolactone in dialysis-dependent ESRD (SPin-D): a randomized, placebo-controlled, multiple dosage trial.

Kidney360, 2023 Feb 10

Effects of Spironolactone on Arrhythmias in Hemodialysis Patients: Secondary Results of the SPin-D Randomized Controlled Trial.

Frontiers in medicine, 2022 Mar 17

Safety and Efficacy of Spironolactone in Dialysis-Dependent Patients: Meta-Analysis of Randomized Controlled Trials.

The international journal of cardiovascular imaging, 2021 Feb 05

The effect of spironolactone on diastolic function in haemodialysis patients.

Lancet (London, England), 2024 Jun 27

Lowering systolic blood pressure to less than 120 mm Hg versus less than 140 mm Hg in patients with high cardiovascular risk with and without diabetes or previous stroke: an open-label, blinded-outcome, randomised trial.

The New England journal of medicine, 2024 Oct 26

Bi- and Monoallelic Variants and Chronic Kidney Disease in West Africans.

Atencion primaria, 1997 Sep 30

[The existing differences between adolescent girls served on a first visit in a family planning center in 2 time periods].

The New England journal of medicine, 2024 Oct 25

Long-Term Effects of Empagliflozin in Patients with Chronic Kidney Disease.

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