Hypertension in patients with polycystic kidney disease – incidence, pathogenesis, prognosis, therapy

Česká verzia

Authors: V. Tesař; J. Reiterová
Authors place of work: Klinika nefrologie 1. lékařské fakulty UK a VFN v Praze, přednosta prof. MU Dr. Vladimír Tesař, DrSc., MBA
Published in the journal: Vnitř Lék 2013; 59(6): 496-500
Category: 80th birthday prof. MUDr. Karla Horkého, DrSc., FACP (Hon.)

Summary

Hypertension is common in patients with autosomal dominant polycystic kidney disease (ADPKD) very early usually already in adolescence and its occurrence precedes the decrease of glomerular filtration rate. Expansion of renal cysts causing local renal ischemia and activation of the renin‑angiotensin system is believed to play a decisive role in its pathogenesis. Hypertension in ADPKD leads to early development of left ventricle hypertrophy and definitely contributes to the progression of chronic renal insufficiency. In ADPKD optimal control of blood pressure dramatically decreases the risk of left ventricle hypertrophy and contributes to its regression, but the beneficial effect of optimal compared to standard blood pressure control on the progression of chronic renal insufficiency has yet to be unequivocally demonstrated. Angiotensin converting enzyme inhibitors and/ or angiotensin receptor blockers are the drugs of choice in the treatment of hypertension in ADPKD. New drugs blocking the growth of renal cysts (e. g. inhibitors of V2 vasopressin antagonists) may have in ADPKD positive impact not only of the growth of the cysts and kidney volume, but also on the rate of loss of glomerular filtration rate. The influence of these drugs on the control of blood pressure, if any, remains uncertain.

Key words:
autosomal dominant polycystic kidney disease – hypertension – treatment of hypertension in ADPKD

Zdroje

1. Ecder T, Chapman AB, Brosnahan GM et al. Effect of antihypertensive therapy on renal function and urinary albumin excretion in hypertensive patients with autosomal dominant polycystic kidney disease. Am J Kidney Dis 2000; 35: 427– 432.

2. Ecder T, Schrier RS. Hypertension in autosomal‑ dominant polycystic kidney disease: early occurrence and unique aspects. J Am Soc Nephrol 2001; 12: 194– 200.

3. Ecder T, Edelstein CL, Fick‑ Brosnahan GM et al. Diuretics versus angiotensin‑converting enzyme inhibitors in autosomal dominant polycystic kidney disease. Am J Nephrol 2001; 21: 98– 103.

4. Gabow PA, Ghapman AB, Johnson AM et al. Renal structure and hypertension in autosomal dominant polycystic kidney disease. Kidney Int 1990; 38: 1177– 1180.

5. Helal I, Reed B, Schrier RW. Emergent early markers of renal progression in autosomal‑ dominant polycystic kidney disease patients. Implications for prevention and treatment. Am J Nephrol 2012; 36: 162– 167.

6. Helal I, McFann K, Reed B et al. Serum uric acid, kidney volume and progression in autosomal‑ dominant polycystic kidney disease. Nephrol Dial Transplant 2013; 28: 380– 385.

7. Higashihara E, Torres VE, Chapman AB et al. Tolvaptan in autosomal dominant polycystic kidney disease: three years’ experience. Clin J Am Soc Nephrol 2011; 6: 2499– 2507.

8. Higashihara F, Horie S, Muto S et al. Renal disease progression in autosomal dominant polycystic kidney disease. Clin Exp Nephrol 2012; 16: 622– 628.

9. Chapman AB, Gabow PA, Schrier RW. Reversible renal failure associated with angiotensin‑converting enzyme inhibitors in polycystic kidney disease. Ann Intern Med 1991; 115: 769– 773.

10. Chapman AB, Johnson AM, Rainguet S et al. Left ventricular hypertrophy in autosomal dominant polycystic kidney disease. J Am Soc Nephrol 1997; 8: 1292– 1297.

11. Chapman AB. Approaches to testing new treatments in autosomal dominant polycystic kidney disease: insights from the CRISP and HALT- PKD studies. Clin J Am Soc Nephrol 2008; 3: 1197– 1204.

12. Chapman AB, Torres VE, Perrone RD et al. The HALT polycystic kidney disease trials: design and implementation. Clin J Am Soc Nephrol 2010; 5: 102– 109.

13. Jafar TH, Stark PC, Schmid CH et al. The effect of angiotensin‑converting‑enzyme inhibitors on progression of advanced polycystic kidney disease. Kidney Int 2005; 67: 265– 271.

14. Kistler AD, Poster D, Krauer F et al. Increases in kidney volume in autosomal dominant polycystic kidney disease can be detected within 6 months. Kidney Int 2009; 75: 235– 241.

15. Klahr S, Breyer JA, Beck GJ et al. Dietary protein restriction, blood pressure control, and the progression of polycystic kidney disease. Modification of Diet in Renal Disease Study Group. J Am Soc Nephrol 1995; 5: 2037– 2047.

16. Nutahara K, Higashihara E, Horie S et al. Calcium channel blocker versus angiotensin II receptor blocker in autosomal dominant polycystic kidney disease. Nephron Clin Pract 2005; 99: c18– c23.

17. Oflaz H, Alisir S, Buyukadin B et al. Biventricular diastolic dysfunction in patients with autosomal‑ dominant polycystic kidney disease. Kidney Int 2005; 68: 2244– 2249.

18. Patch C, Charlton J, Roderick PJ et al. Use of antihypertensive medications and mortality of patients with autosomal dominant polycystic kidney disease: a population‑based study. Am J Kidney Dis 2011; 57: 856– 872.

19. Perrone RD, Abebe KZ, Schrier RW et al. Cardiac magnetic resonance assessment of left ventricular mass in autosomal dominant polycystic kidney disease. Clin J Am Soc Nephrol 2011; 6: 2508– 2515.

20. Schrier R, McFann K, Johnson A et al. Cardiac and renal effects of standard versus rigorous blood pressure control in autosomal‑ dominant polycystic kidney disease: results of a seven‑year prospective randomized study. J Am Soc Nephrol 2002; 13: 1733– 1739.

21. Schrier RW. Renal volume, renin‑angiotensin‑aldosterone system, hypertension, and left ventricular hypertrophy in patients with autosomal dominant polycystic kidney disease. J Am Soc Nephrol 2009; 20: 1888– 1893.

22. Torres VE, Donovan KA, Scicli G et al. Synthesis of renin by tubulocystic epithelium in autosomal- dominant polycystic kidney disease. Kidney Int 1992; 42: 364– 373.

23. Torres VE, Harris PC, Pirson Y. Autosomal dominant polycystic kidney disease. Lancet 2007; 369: 1287– 1301.

24. Torres VE, Chapman AB, Perrone RD et al. Analysis of baseline parameters in the HALT polycystic kidney disease trials. Kidney Int 2012; 81: 577– 585.

25. Torres VE, Chapman AB, Devuyst O et al. Tolvaptan in patients with autosomal dominant polycystic kidney disease. N Engl J Med 2012; 367: 2407– 2418.

26. Xu R, Franchi F, Miller B et al. Polycystic kidney have decreased vascular density: a micro‑CT study. Microcirculation 2013; 20: 183– 189.

27. Zeltner R, Poliak R, Stiasny B et al. Renal and cardiac effect of antihypertensive treatment with ramipril vs metoprolol in autosomal dominant polycystic kidney disease. Nephrol Dial Transplant 2008; 23: 573– 579.

28. Zeier M, Geberth S, Schmidt KG et al. Elevated blood pressure profile and left ventricular mass in children and young adults with autosomal dominant polycystic kidney disease. J Am Soc Nephrol 1993; 3: 1451– 1457.