Table 2 Level of proteinuria and the goal of antihypertensive therapy with respect to underlying disease of CKD

From: Chapter 12. Secondary hypertension

Underlying disease Glomerular capillary pressure Proteinuriaa (g day−1) Target blood pressure (mm Hg) Recommended antihypertensive drugs
Diabetic nephropathy,
High Usually 1 g day−1 <125/75b RA system inhibitors
polycystic kidney,
renal interstitial disorders
Normal–low Usually <1 g day−1 <130/80 Any typesc
  1. Abbreviations: CKD, chronic kidney disease; RA, renin–angiotensin.
  2. Some patients with diabetic nephropathy or glomerulonephritis are treated with RA system inhibitors to protect the kidney even in the absence of hypertension.
  3. In CKD patients without proteinuria, kidney-protecting actions of RA system inhibitors have not been established.
  4. aA reference urinary protein level of 1 g day−1 was roughly established.
  5. bIn diabetic nephropathy or glomerulonephritis patients showing a urinary protein level of <1 g day−1, the target blood pressure values are <130/80 mm Hg.
  6. cAs urinary protein level increases, strict blood pressure control with RA system inhibitors should be recommended to lower glomerular capillary pressure.