Chronic Kidney Disease and Hypertension

A Destructive Combination

Leticia Buffet, PharmD; Charlotte Ricchetti, PharmD, BCPS, CDE


US Pharmacist 

In This Article


Hypertension is one of the leading causes of CKD due to the deleterious effects that increased BP has on kidney vasculature. Long-term, uncontrolled, high BP leads to high intraglomerular pressure, impairing glomerular filtration.[12,13] Damage to the glomeruli lead to an increase in protein filtration, resulting in abnormally increased amounts of protein in the urine (microalbuminuria or proteinuria).[12,13] Microalbuminuria is the presentation of small amounts of albumin in the urine and is often the first sign of CKD. Proteinuria (protein-to-creatinine ratio ≥200 mg/g) develops as CKD progresses, and is associated with a poor prognosis for both kidney disease and CVD.[3,4,14]

As discussed previously, the relationship between CKD and HTN is cyclic, as CKD can contribute to or cause HTN. Elevated BP leads to damage of blood vessels within the kidney, as well as throughout the body. This damage impairs the kidney's ability to filter fluid and waste from the blood, leading to an increase of fluid volume in the blood—thus causing an increase in BP.