The lingering dilemma of arterial pressure in CKD: What do we know, where do we go?

Rajiv Agarwal, Alberto Martinez-Castelao, Andrzej Wiecek, Ziad Massy, Gultekin Suleymanlar, Alberto Ortiz, Peter J. Blankestijn, Adrian Covic, Friedo W. Dekker, Kitty J. Jager, Bengt Lindholm, David Goldsmith, Danilo Fliser, Gerard London, Carmine Zoccali

Research output: Contribution to journalReview article

4 Scopus citations


Despite many advances in the management of hypertensive chronic kidney disease (CKD) patients, both on and off dialysis, there exist several gaps in our knowledge. Although the modern techniques to measure blood pressure (BP) indirectly have been available for a long time, among those with CKD, how to best assess hypertension and the level to which it should be lowered are mired in controversy. Other controversial areas relate to a lack of a consensus definition of hypertension among hemodialysis patients, uncertainty in the definition and assessment of volume excess, and the lack of adequately powered randomized trials to evaluate the level to which BP can be lowered in those on dialysis. This review discusses the limitations of the available evidence base and suggests areas for future research. Suggestions include evaluation of techniques to assess volume, randomized trials to target different levels of BP among hypertensive hemodialysis patients, evaluation of ambulatory BP monitoring, and non-pharmacological means to lower BP in CKD. It is hoped that among patients with CKD these data will improve the dismal cardiovascular outcomes.

Original languageEnglish (US)
Pages (from-to)17-20
Number of pages4
JournalKidney International Supplements
Issue number1
StatePublished - Jun 1 2011


  • ambulatory blood pressure
  • cardiovascular disease
  • CKD
  • hypervolemia
  • outcome studies; risk factors

ASJC Scopus subject areas

  • Nephrology

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    Agarwal, R., Martinez-Castelao, A., Wiecek, A., Massy, Z., Suleymanlar, G., Ortiz, A., Blankestijn, P. J., Covic, A., Dekker, F. W., Jager, K. J., Lindholm, B., Goldsmith, D., Fliser, D., London, G., & Zoccali, C. (2011). The lingering dilemma of arterial pressure in CKD: What do we know, where do we go? Kidney International Supplements, 1(1), 17-20.