Hypertension and nephrology

[Lipid-lowering treatment in chronic kidney disease in light of new studies and recommendations]


SEPTEMBER 13, 2021

Hypertension and nephrology - 2021;25(04)

DOI: https://doi.org/10.33668/hn.25.017

[Summary – Chronic kidney disease (CKD), which affects 10-14% of the population, dramatically increases the incidence and severity of cardiovascular (CV) disease, leading to death in the majority of patients before kidney replacement therapy. The current CV risk scorecards in CKD significantly underestimate the real risk and are therefore not applicable. For CV risk assessment it is recommended to use the combined GFR/proteinuria table also, which is used for CKD classification, was also adopted by the Hungarian CV Consensus Conference last year. The benefit of cholesterol- lowering treatment has also been demonstrated in CKD, and a 1 mmol/l reduction in LDL-c, as in the general population, reduces the incidence of major CV events by 20%. Recent clinical trials have clearly indicated that the lower the LDL-c values achieved, the lower the risk of future CV events, and therefore the new recommendations have tightened the LDL-c values to be achieved. ]


  1. Debreceni Egyetem, Klinikai Központ, Belgyógyászati Intézet, Nefrológiai Tanszék, Debrecen



Further articles in this publication

Hypertension and nephrology

[Membranous glomerulopathy: two cases]

BÓDI Brigitta, FEJES Réka, KARDOS Magdolna, DEÁK György

[Summary – Membranous glomerulopathy (MGP) is the most frequent cause of nephrotic syndrome in adults. It is classified as a primary autoimmune disease or secondary MGP due to malignancies, autoimmune diseases, infections or adverse drug reactions. Here we present two cases of MGP.]

Hypertension and nephrology

[Hypertension-infertility. Can be any connection between them?]


[Summary – Considering the pathomechanism, the risk factors, as well as the environmental and toxic effects, some associated illnesses, unhealthy life-style habits in the background of hypertension and infertility, significant overlapping can be found. The question arises; does play any role the hypertension in the development of infertility? In this article the author review the connection between the hypertension and infertility. ]

Hypertension and nephrology

[May measurement month: analysis of the Hungarian results of years 2017 and 2019]

NEMCSIK János, PÁLL Dénes, JÁRAI Zoltán

[Cardiovascular (CV) diseases are not only the leading causes of mortality in Hungary, but also the mortality rate is excessively high compared with the average of European Union, so screening programs identifying subjects with elevated blood pressure (BP) is of utmost importance. May Measurement Month (MMM) is an annual global initiative which began in 2017 aimed at raising awareness of high BP. Hungary, through the Hungarian Society of Hypertension has joined the campaign of MMM from the beginning. The results of years 2017 and 2019 are presented in this paper. ]

Hypertension and nephrology

[The translation of scientific evidence into arterial hypertension guideline (ESC/ESH Guidelines for the management of arterial hypertension): certainty and uncertainty in decision-making]


[Clinical practice guidelines summarise the existing knowledge of a given medical field, helping healthcare professionals to make medical conscious medical decisions. Our present study aims to analyse the Arterial Hypertension (AH) Guideline issued by the ESC/ESH to determine what overall certainty it has for making effective decisions.]

Hypertension and nephrology

[Facts and misbeliefs regarding thiazides and thiazide-like diuretics]


[Diuretics are listed in hypertension guidelines as part of first-line treatment options unvariably. A lot of discussion has been directed at side effect profiles and as a result, has created a perhaps disproportionate fear of the metabolic effects and potential increased risk of skin cancer that can be associated with diuretics. Data, however, show that the risk of a clinically meaningful change in laboratory parameters is very low, their carcinogenic potential is not fully proved, whereas the benefits of volume control and natriuresis are high and the reductions in morbidity and mortality are clinically significant. Moreover, several international guidelines have started making a distinction between thiazides (hydrochlorothiazide) and thiazide-like (chlorthalidone, indapamide) diuretics; and some of them now recommend longer acting thiazide-like diuretics. Based on this differentiation chlorthalidone and indapamide may need to be subdivided further into separate classifications. Nevertheless, it’s worth to know that indapamide exists in two formulation with ]

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Risk factors for ischemic stroke and stroke subtypes in patients with chronic kidney disease

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Hypertension and nephrology

[Case report of supine hypertension and extreme reverse dipping phenomenon decades after kidney transplantation]

BATTA Dóra, KŐRÖSI Zita Beáta, NEMCSIK János

[Supine hypertension, a consequence of autonomic neuropathy, is a rarely recognized pathological condition. Reported diseases in the background are pure autonomic failure, multiple system atrophy, Parkinson’s disease, diabetes and different autoimmune disorders. In our case report we present a case of supine hypertension which developed in a patient decades after kidney transplantation. The patient was followed for 25 months and we demonstrate the effect of the modification of antihypertensive medications. At the time of the diagnosis supine hypertension appeared immediately after laying down (office sitting blood pressure (BP): 143/101 mmHg; office supine BP: 171/113 mmHg) and on ambulatory blood pressure monitoring (ABPM) extreme reverse dipping was registered (daytime BP: 130/86 mmHg, nighttime BP: 175/114 mmHg). After the modification of the antihypertensive medications in multiple times, both office supine BP (office sitting BP: 127/92 mmHg; office supine BP: 138/100 mmHg) and on ABPM nighttime BP improved markedly (daytime BP: 135/92 mmHg, nighttime BP: 134/90 mmHg). In conclusions, our case report points out that autonomic neuropathy-caused supine hypertension and extreme reverse dipping can develop in chronic kidney disease, after kidney transplantation. The modification of the antihypertensive medications can slowly restore this pathological condition.]

Hypertension and nephrology

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