Control blood pressure patients with chronic nephritis

Chronic nephritis, and the remaining (or) lesions compensatory renal units in the high hemodynamic status, systemic hypertension undoubtedly add to this condition, resulting in sexual glomerular injury, it should be for patients with chronic nephritis active control of hypertension to prevent the deterioration of renal function.
In recent years, through a series of studies confirmed that the majority of scholars have angiotensin-converting enzyme inhibitors as first-line antihypertensive drugs. In recent years, many clinical studies confirmed the calcium antagonists, such as nifedipine, nicardipine and equal treatment of hypertension and retard deterioration of renal function is more positive effect. Study, calcium antagonists goals despite a slight expansion of the role of small arteries, but it has significantly decreased the role of systemic blood pressure, it could not involved or only partially involved in glomerular hemodynamics high, high metabolic status improved; In addition, calcium antagonists to reduce oxygen consumption, anti-platelet aggregation, through the cell membrane effects of reduced calcium deposition in the mesenchymal cells excessive oxidation and reduction, so as to achieve stability and reduce kidney damage kidney function. Clinical reports, short-term (four weeks) or long (1 to 2 years) with calcium antagonists in treatment of chronic renal failure in patients with glomerulonephritis, and did not find any glomerular injury, but it clearly demonstrated and angiotensin converting enzyme inhibitors are very similar delayed effect of the deterioration of renal function. And angiotensin-converting enzyme inhibitor different, as it generally ratchet urinary protein role. It should be noted that some scholars believe that calcium antagonists have an impact on renal function, there is need for more long-term observation.
Β-blockers, such as the United States and metoprolol, Atenolol, on the renin-dependent hypertension good effect. Β-blockers reduce renin a role, although the drug reduced cardiac output, but did not affect renal blood flow and GFR, it is also used in the treatment of renal hypertension. It should be noted that some of β-blockers, such as Atenolol and naphthalene hydroxyl peace of fat-soluble low, since the renal excretion, so they should pay attention to renal insufficiency and extended medication dose adjustment time.
In addition, the vasodilator drugs such as hydralazine also antihypertensive effect, it can and β-blockers combined to reduce  vasodilating drugs stimulate renin angiotensin system, such as side effects (such as a heartbeat accelerated, Shuinazhuliu ), and improve treatment. Hydralazine 200 mg daily general, but must be vigilant against the drug-induced lupus erythematosus-like syndrome may be.
With edema, if the renal function properly, plus Thiazide diuretics; of poor renal function (serum creatinine> 200 μ mol / L), Thiazide of poor or ineffective drugs, should be replaced myeloid loop diuretic agent. Application diuretics should pay attention to the body electrolyte imbalance, and we should pay attention to a heavier hyperlipidemia, hypercoagulable state trend.