Impact of antihypertensive therapy on progression of experimental renal disease

Hypertension is common in patients with renal disease and, when uncontrolled, accelerates the rate of progression to end stage renal failure. There is considerable evidence that antihypertensive therapy can slow the rate of decline in kidney function in these patients. However, controversy exists regarding the mechanisms by which antihypertensive agents prevent kidney damage as well as the relative utility of different classes of drugs. This paper will focus on a series of studies, including several conducted in our laboratory, in which the impact of antihypertensive agents on kidney structure and function have been examined in experimental models of progressive kidney failure. Taken together, these studies suggest that most drugs that reduce systemic blood pressure will also lessen kidney damage, albeit to varying degrees and by different mechanisms.