Renal and Systemic Vascular Resistance in Chronic Kidney Disease (CKD)

The Role of Renal and Peripheral Vascular Resistance in Chronic Kidney Disease

Patients with reduced kidney function have a higher risk of heart disease and death. Studies have shown that blood vessels in patients with hypertension change with a decrease of lumen size and growth of the vessel wall. By treating patients with antihypertensive certain medication vessel lumen and walls normalize. Treating hypertension in patients with chronic kidney disease slows the progression of kidney function loss.

The aim is to compare different degrees of antihypertensive medication in patients with chronic kidney disease and hypertension will slow the progression of kidney loss.

Inclusion Criteria:

• eGFR 15-60 ml/min for at least 3 months
• Blood pressure > 130 mmHg systolic og >80 mmHg diastolic (patients without antihypertensive treatment or in treatment with Beta-blockers, ACEi, ARBs or CCB not in maximum dosi).
• Blood pressure < 130 mmHg systolic og < 80 mmHg diastolic (patients receiving Beta-blockers, ACEi, ARBs og CCB).
• Fertile women using safe contraceptives

Exclusion Criteria:

• Ultrasound verified Polycystic Kidney Disease (ADPKD)
• Claustrophobia (MRi scan).
• Contraindications to MRi.
• Pregnancy or wish to become pregnant in the study period.
• Nephrotic syndrome with gross edema.
• Known allergy to any study medication.
• Blood pressure < 130 mmHg systolic or < 80 mmHg diastolic without antihypertensive treatment.
• Blood pressure > 130 mmHg systolic or > 80 mmHg diastolic and in maximum dosages of all three Beta-blockers, ACEi (ARBs) and CCB.