PREVALENCE, MANAGEMENT, AND OUTCOME OF RESISTANT HYPERTENSION IN PEOPLE WITH CKD : A COMPREHENSIVE SYSTEMATIC REVIEW
DOI:
https://doi.org/10.61841/y3hv1s89Keywords:
CKD, resistant hypertension, outcomes, patiromerAbstract
Background: Patients with chronic kidney disease (CKD) are susceptible to resistant hypertension, which is a serious problem. Patients should take into account reversible causes as the prevalence of this ailment is difficult to ascertain. Its development is influenced by the renin-angiotensin-aldosterone system and the sympathetic nervous system. The efficacy of current hypertension treatments, such as medication and lifestyle modifications, in treating resistant hypertension is low. Recent studies have shown a reduction in blood pressure equivalent to that of a single antihypertensive drug in less severe cases of hypertension.
Methods: Following PRISMA 2020 guidelines, this systematic review concentrated on full-text English literature published between 2014 and 2024. Editorials and review articles that appeared in the same journal as the submission were not accepted without a DOI. The literature was assembled using a variety of online databases, including ScienceDirect, PubMed, and SagePub.
Result: The study screened about 3.000 publications using reputable sources including Science Direct, SagePub, and PubMed. Five papers were found to be pertinent for systematic investigation, after which the entire material was examined in more detail.
Conclusion: It has been demonstrated that patiromer, a K1-binding drug, improves cardiovascular outcomes in patients with hypertension and chronic kidney disease (CKD). Phase II trial results demonstrated that patiromer can safely permit spironolactone use and prevent hyperkalemia, hence reducing renin-angiotensin-aldosterone system inhibitor non-use in patients with heart failure refractory to exercise. Long-term findings regarding the effects on the kidneys and heart are nevertheless required. Treatment for renal denervation has demonstrated encouraging outcomes in lowering blood pressure without side effects.
References
Calhoun, D. A., Jones, D., Textor, S., Goff, D. C., Murphy, T. P., Toto, R. D., White, A., Cushman, W. C., White, W., Sica, D., Ferdinand, K., Giles, T. D., Falkner, B., & Carey, R. M. (2008). Resistant hypertension: Siagnosis, evaluation, and treatment a scientific statement from the american heart association professional education committee of the council for high blood pressure research. Hypertension, 51(6), 1403–1419. https://doi.org/10.1161/HYPERTENSIONAHA.108.189141
2. Gajulapalli, R. D., Chahine, J., Rader, F., & Aneja, A. (2020). Procedures and devices to treat resistant hypertension in chronic kidney disease. Cleveland Clinic Journal of Medicine, 87(7), 435–443. https://doi.org/10.3949/ccjm.87a.19099
3. Fay, K. S., & Cohen, D. L. (2021). Resistant Hypertension in People With CKD: A Review. American Journal of Kidney Diseases, 77(1), 110–121. https://doi.org/10.1053/j.ajkd.2020.04.017
4. Mennuni, S., Rubattu, S., Pierelli, G., Tocci, G., Fofi, C., & Volpe, M. (2014). Hypertension and kidneys: Unraveling complex molecular mechanisms underlying hypertensive renal damage. Journal of Human Hypertension, 28(2), 74–79. https://doi.org/10.1038/jhh.2013.55
5. Peralta, C. A., Norris, K. C., Li, S., Chang, T. I., Tamura, M. K., Jolly, S. E., Bakris, G., McCullough, P. A., Shlipak, M., & KEEP Investigators, for the. (2012). Blood Pressure Components and End-stage Renal Disease in Persons With Chronic Kidney Disease. Archives of Internal Medicine, 172(1), 41. https://doi.org/10.1001/archinternmed.2011.619
6. Mohammad, A. A., Nawar, K., Binks, O., & Abdulla, M. H. (2024). Effects of renal denervation on kidney function in patients with chronic kidney disease: a systematic review and meta-analysis. Journal of Human Hypertension, 38(1), 29–44. https://doi.org/10.1038/s41371-023-00857-3
7. Jankowski, J., Floege, J., Fliser, D., Böhm, M., & Marx, N. (2021). Cardiovascular Disease in Chronic Kidney Disease Pathophysiological Insights and Therapeutic Options. Circulation, 143(11), 1157–1172. https://doi.org/10.1161/CIRCULATIONAHA.120.050686
8. Stevens, P. E., O’Donoghue, D. J., De Lusignan, S., Van Vlymen, J., Klebe, B., Middleton, R., Hague, N., New, J., & Farmer, C. K. T. (2007). Chronic kidney disease management in the United Kingdom: NEOERICA project results. Kidney International, 72(1), 92–99. https://doi.org/10.1038/sj.ki.5002273
9. Thomas, G., Xie, D., Chen, H.-Y., & Anderson, A. (2016). PREVALENCE AND PROGNOSTIC SIGNIFICANCE OF APPARENT TREATMENT RESISTANT HYPERTENSION IN CHRONIC KIDNEY DISEASE: A REPORT FROM THE CRIC STUDY. Hypertension, 67(2), 387–396. https://doi.org/10.1161/HYPERTENSIONAHA.115.06487.PREVALENCE
10. Irvin, M. R., Shimbo, D., Mann, D. M., Reynolds, K., Krousel-Wood, M., Limdi, N. A., Lackland, D. T., Calhoun, D. A., Oparil, S., & Muntner, P. (2012). Prevalence and Correlates of Low Medication Adherence in Apparent Treatment-Resistant Hypertension. Journal of Clinical Hypertension, 14(10), 694–700. https://doi.org/10.1111/j.1751-7176.2012.00690.x
11. Liu, S., Bian, R., Qian, Y., Liao, H., Gao, X., Zhang, Y., & Dong, W. (2023). Catheter-based renal denervation in Chinese patients with chronic kidney disease and uncontrolled hypertension. Journal of Clinical Hypertension, 25(1), 71–77. https://doi.org/10.1111/jch.14605
12. Kaur, J., Young, B. E., & Fadel, P. J. (2017). Sympathetic overactivity in chronic kidney disease: Consequences and mechanisms. International Journal of Molecular Sciences, 18(8). https://doi.org/10.3390/ijms18081682
13. Rossignol, P., Williams, B., Mayo, M. R., Warren, S., Arthur, S., Ackourey, G., White, W. B., & Agarwal, R. (2020). Patiromer versus placebo to enable spironolactone use in patients with resistant hypertension and chronic kidney disease (AMBER): results in the pre-specified subgroup with heart failure. European Journal of Heart Failure, 22(8), 1462–1471. https://doi.org/10.1002/ejhf.1860
14. Agarwal, R., Rossignol, P., Budden, J., Mayo, M. R., Arthur, S., Williams, B., & White, W. B. (2021). Patiromer and Spironolactone in Resistant Hypertension and Advanced CKD: Analysis of the Randomized AMBER Trial. Kidney360, 2(3), 425–434. https://doi.org/10.34067/KID.0006782020
15. Xia, M., Liu, T., Chen, D., & Huang, Y. (2021). Efficacy and safety of renal denervation for hypertension in patients with chronic kidney disease: a meta-analysis. International Journal of Hyperthermia, 38(1), 732–742. https://doi.org/10.1080/02656736.2021.1916100
16. Komajda, M., Cowie, M. R., Tavazzi, L., Ponikowski, P., Anker, S. D., & Filippatos, G. S. (2017). Physicians’ guideline adherence is associated with better prognosis in outpatients with heart failure with reduced ejection fraction: the QUALIFY international registry. European Journal of Heart Failure, 19(11), 1414–1423. https://doi.org/10.1002/ejhf.887
17. Pitt, B., Anker, S. D., Bushinsky, D. A., Kitzman, D. W., Zannad, F., & Huang, I. Z. (2011). Evaluation of the efficacy and safety of RLY5016, a polymeric potassium binder, in a double-blind, placebo-controlled study in patients with chronic heart failure (the PEARL-HF) trial. European Heart Journal, 32(7), 820–828. https://doi.org/10.1093/eurheartj/ehq502
18. Williams, B., Macdonald, T. M., Morant, S., Webb, D. J., Sever, P., McInnes, G., Ford, I., Cruickshank, J. K., Caulfield, M. J., Salsbury, J., Mackenzie, I., Padmanabhan, S., & Brown, M. J. (2015). Spironolactone versus placebo, bisoprolol, and doxazosin to determine the optimal treatment for drug-resistant hypertension (PATHWAY-2): A randomised, double-blind, crossover trial. The Lancet, 386(10008), 2059–2068. https://doi.org/10.1016/S0140-6736(15)00257-3
19. Carey, R. M., Calhoun, D. A., Bakris, G. L., Brook, R. D., Daugherty, S. L., Dennison-Himmelfarb, C. R., Egan, B. M., Flack, J. M., Gidding, S. S., Judd, E., Lackland, D. T., Laffer, C. L., Newton-Cheh, C., Smith, S. M., Taler, S. J., Textor, S. C., Turan, T. N., & White, W. B. (2018). Resistant hypertension: Detection, evaluation, and management a scientific statement from the American Heart Association. In Hypertension (Vol. 72, Issue 5). https://doi.org/10.1161/HYP.0000000000000084
20. Alencar de Pinho, N., Levin, A., Fukagawa, M., Hoy, W. E., Pecoits-Filho, R., Reichel, H., Robinson, B., Kitiyakara, C., Wang, J., Eckardt, K. U., Jha, V., Oh, K. H., Sola, L., Eder, S., de Borst, M., Taal, M., Feldman, H. I., Stengel, B., Djurdjev, O., … Shardlow, A. (2019). Considerable international variation exists in blood pressure control and antihypertensive prescription patterns in chronic kidney disease. Kidney International, 96(4), 983–994. https://doi.org/10.1016/j.kint.2019.04.032
21. Baek, S. H., Cha, R. H., Kang, S. W., Park, C. W., Cha, D. R., Kim, S. G., Yoon, S. A., Kim, S., Han, S. Y., Park, J. H., Chang, J. H., Lim, C. S., Kim, Y. S., & Na, K. Y. (2019). Circulating renalase predicts all-cause mortality and renal outcomes in patients with advanced chronic kidney disease. Korean Journal of Internal Medicine, 34(4), 858–866. https://doi.org/10.3904/kjim.2017.058
22. Weber, M. A., Mahfoud, F., Schmieder, R. E., Kandzari, D. E., Tsioufis, K. P., Townsend, R. R., Kario, K., Böhm, M., Sharp, A. S. P., Davies, J. E., Osborn, J. W., Fink, G. D., Euler, D. E., Cohen, D. L., Schlaich, M. P., & Esler, M. D. (2019). Renal Denervation for Treating Hypertension: Current Scientific and Clinical Evidence. JACC: Cardiovascular Interventions, 12(12), 1095–1105. https://doi.org/10.1016/j.jcin.2019.02.050
23. Peene, B., & Benhalima, K. (2014). Sodium glucose transporter protein 2 inhibitors: Focusing on the kidney to treat type 2 diabetes. Therapeutic Advances in Endocrinology and Metabolism, 5(5), 124–136. https://doi.org/10.1177/2042018814553965
24. Townsend, R. R., Mahfoud, F., Kandzari, D. E., Kario, K., Pocock, S., Weber, M. A., Ewen, S., Tsioufis, K., Tousoulis, D., Sharp, A. S. P., Watkinson, A. F., Schmieder, R. E., Schmid, A., Choi, J. W., East, C., Walton, A., Hopper, I., Cohen, D. L., Wilensky, R., … Chasen, C. (2017). Catheter-based renal denervation in patients with uncontrolled hypertension in the absence of antihypertensive medications (SPYRAL HTN-OFF MED): a randomised, sham-controlled, proof-of-concept trial. The Lancet, 390(10108), 2160–2170. https://doi.org/10.1016/S0140-6736(17)32281-X
25. Böhm, M., Kario, K., Kandzari, D. E., Mahfoud, F., Weber, M. A., Schmieder, R. E., Tsioufis, K., Pocock, S., Konstantinidis, D., Choi, J. W., East, C., Lee, D. P., Ma, A., Ewen, S., Cohen, D. L., Wilensky, R., Devireddy, C. M., Lea, J., Schmid, A., … Zidar, D. (2020). Efficacy of catheter-based renal denervation in the absence of antihypertensive medications (SPYRAL HTN-OFF MED Pivotal): a multicentre, randomised, sham-controlled trial. The Lancet, 395(10234), 1444–1451. https://doi.org/10.1016/S0140-6736(20)30554-7
26. Mauriello, A., Rovella, V., Anemona, L., Servadei, F., Giannini, E., Bove, P., Anselmo, A., Melino, G., & Di Daniele, N. (2015). Increased sympathetic renal innervation in hemodialysis patients is the anatomical substrate of sympathetic hyperactivity in end-stage renal disease. Journal of the American Heart Association, 4(12), 1–10. https://doi.org/10.1161/JAHA.115.002426
27. Spiering, W., Williams, B., Van der Heyden, J., van Kleef, M., Lo, R., Versmissen, J., Moelker, A., Kroon, A., Reuter, H., Ansel, G., Stone, G. W., Bates, M., Spiering, W., Williams, B., & Bates, M. (2017). Endovascular baroreflex amplification for resistant hypertension: a safety and proof-of-principle clinical study. The Lancet, 390(10113), 2655–2661. https://doi.org/10.1016/S0140-6736(17)32337-1
28. Chrysochou, C., & Kalra, P. A. (2009). Epidemiology and Natural History of Atherosclerotic Renovascular Disease. Progress in Cardiovascular Diseases, 52(3), 184–195. https://doi.org/10.1016/j.pcad.2009.09.001
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Landong Sijabat, Guinanti Novettiandari
This work is licensed under a Creative Commons Attribution 4.0 International License.
Licensing
Ninety Nine Publication publishes articles under the Creative Commons Attribution 4.0 International License (CC BY 4.0). This licensing allows for any use of the work, provided the original author(s) and source are credited, thereby facilitating the free exchange and use of research for the advancement of knowledge.
Detailed Licensing Terms
Attribution (BY): Users must give appropriate credit, provide a link to the license, and indicate if changes were made. Users may do so in any reasonable manner, but not in any way that suggests the licensor endorses them or their use.
No Additional Restrictions: Users may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
