What is your approach to managing patients with hypertensive crisis and avoiding brisk reductions in blood pressure and subsequent ischemic acute kidney injury?

In my patients who tend to have some degree of renal dysfunction, I find myself using a lot of diuretics. In my experience, many of these patients are significantly volume overloaded. Diuretics tend to work the best to lower the blood pressure and do it in a slow fashion. Of course, if the blood pre...

In a hypertensive emergency, I find it challenging to tell if the worsening of kidney function is caused by the brisk reductions in blood pressure, or if the hypertensive emergency itself already did the damage to the kidney, and the "brisk" reduction in blood pressure may actually help it.

According...