Should beta-blockers be used to control hypertension in people with chronic kidney disease?

Seminars in Nephrology
Peter D Hart, George Bakris


Activation of the sympathetic nervous system is common in patients with chronic kidney disease, plays an important role in the genesis of hypertension, the rate of decrease of renal function, and is associated with the increased cardiovascular morbidity and mortality seen in these patients. beta-blockers are potent antihypertensive agents but differ in their hemodynamic effects on renal function. The cardioselective beta-blockers such as atenolol and metoprolol are known to retard the progression of renal diseases, but to a lesser degree compared with blockers of the renin-angiotensin-aldosterone system. However, the newer vasodilating beta-blockers such as carvedilol and nebivolol have different effects on renal hemodynamics and function primarily because of its greater adjunctive alpha1-blocking activity. Carvedilol decreases renal vascular resistance and prevents reductions in the glomerular filtration rate and renal blood flow in patients with hypertension with or without impaired kidney function. In addition, carvedilol may retard progression of albuminuria, and provide cardiorenal protection in chronic kidney disease patients with hypertension, congestive heart failure, and at high risk for sudden cardiac death.


Jan 1, 1992·The Clinical Investigator·A G Dupont
Jan 1, 1992·Journal of Cardiovascular Pharmacology·K Tomita, F Marumo
Mar 28, 1992·BMJ : British Medical Journal·P T Sawicki, M Berger
Jan 10, 1993·The New England Journal of Medicine·R L ConverseR G Victor
Mar 28, 1985·The New England Journal of Medicine·M E WilliamsF H Epstein
Jan 1, 1986·American Journal of Nephrology·P ZechJ F Poncet
Jun 6, 1987·British Medical Journal·H H ParvingP A Svendsen
Jun 1, 1982·British Journal of Clinical Pharmacology·P L MaliniB Magnani
Mar 1, 1980·Clinical Pharmacokinetics·K U SeilerO Wassermann
Jan 1, 1981·European Journal of Clinical Pharmacology·W KirchM Schäfer
Oct 1, 1994·BMJ : British Medical Journal·T HannedoucheJ M Suo
May 1, 1993·Journal of Clinical Pharmacology·K C Abbott, George Bakris
Jun 1, 1996·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·K AmannE Ritz
Nov 20, 1998·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·G Eknoyan
Apr 29, 1999·The New England Journal of Medicine·Gerry LigtenbergHein A Koomans
Mar 17, 2001·Diabetic Medicine : a Journal of the British Diabetic Association·S MehrotraK A Earle
May 23, 2001·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·S R OrthE Ritz
Jan 12, 2002·Kidney International·Maristela Lika OnozatoChristopher S Wilcox
May 11, 2002·Current Hypertension Reports·Vito M Campese, Ewa Krol
Aug 10, 2002·American Journal of Nephrology·Jerry McCauleyRon Shapiro
Oct 2, 2002·Annals of Internal Medicine·R Scott WrightAllan S Jaffe
Oct 9, 2002·Circulation·Martin HausbergKarl Heinz Rahn
Mar 8, 2003·Hypertension·Gerald F DiBona
Nov 26, 2003·Journal of the American Society of Nephrology : JASN·Inge H H T KleinPeter J Blankestijn
Apr 14, 2004·Journal of Internal Medicine·V GinerJ Redón
Apr 29, 2004·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Kidney Disease Outcomes Quality Initiative (K/DOQI)
May 7, 2004·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Ernesto PaolettiGiuseppe Cannella
Jul 15, 2004·Seminars in Dialysis·Matthias P Hörl, Walter H Hörl


Feb 14, 2014·Current Hypertension Reports·Piotr Czarniak, Aleksandra Zurowska
Jul 6, 2014·BioMed Research International·Mohamed A MorsyMagdy K Hassan
Jan 30, 2010·American Journal of Nephrology·Melvin R HaydenJames R Sowers
Jul 10, 2010·Journal of the American Society of Nephrology : JASN·Daniel J BrotmanJosef Coresh
Dec 17, 2008·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Rigas Kalaitzidis, George Bakris
Sep 22, 2015·Biology·John S Torday
May 1, 2015·Canadian Journal of Physiology and Pharmacology·Hala Salah Abdel Kawy
Jul 22, 2016·Circulation Journal : Official Journal of the Japanese Circulation Society·Kentaro JujoNobuhisa Hagiwara
Oct 12, 2012·Hypertension Research : Official Journal of the Japanese Society of Hypertension·Anastasia G PtinopoulouAnastasios N Lasaridis
Mar 26, 2011·American Journal of Therapeutics·Angela Brown, Becky Captain
Oct 11, 2008·The Journal of Clinical Hypertension·George BakrisAmerican Society of Hypertension Writing Group
Apr 7, 2020·British Journal of Pharmacology·Feby SaviraBing H Wang
Aug 13, 2008·Current Opinion in Nephrology and Hypertension·Irena Duka, George Bakris
Feb 26, 2016·British Journal of Clinical Pharmacology·Daniel V NevesEduardo B Coelho
Jun 3, 2018·Aging Clinical and Experimental Research·Klara KomiciGiuseppe Rengo

Related Concepts

Related Feeds

Anti-Arrhythmic Drug Therapies

Anti-arrhythmic drugs are used to prevent abnormal heart rhythms. These medications are used in conditions including, ventricular tachycardia, ventricular fibrillation and atrial fibrillation. Discover the latest research on anti-arrhythmic drug therapies here.


Cardiomyopathy is a disease of the heart muscle, that can lead to muscular or electrical dysfunction of the heart. It is often an irreversible disease that is associated with a poor prognosis. There are different causes and classifications of cardiomyopathies. Here are the latest discoveries pertaining to this disease.

Adrenergic Receptors: Trafficking

Adrenergic receptor trafficking is an active physiological process where adrenergic receptors are relocated from one region of the cell to another or from one type of cell to another. Discover the latest research on adrenergic receptor trafficking here.

Antihypertensive Agents: Mechanisms of Action

Antihypertensive drugs are used to treat hypertension (high blood pressure) which aims to prevent the complications of high blood pressure, such as stroke and myocardial infarction. Discover the latest research on antihypertensive drugs and their mechanism of action here.