[Treatment of arterial hypertension with renal involvement].

TREATMENT GUIDELINES: To prevent the development of hypertensive renal disease of progression of underlying renal disease, the blood pressure goal should be 130/85 mmHg or less if possible when proteinuria exceeds 1 g/24 h. ANTIHYPERTENSIVE DRUGS: Converting enzyme inhibitors are recommended in patients with non-diabetic renal disease and, as first-line therapy, in diabetics with microalbuminurea or patent diabetic nephropathy with or without hypertension. TREATMENT ONSET: Converting enzyme inhibitors should be started progressively with a lower final dosage in case of renal failure. Creatinemia and kaliemia must be monitored. Combination therapy with diuretics is generally used, but potassium-sparing diuretics are contraindicated due to the risk of hyperkaliemia. Reduced sodium intake is essential to obtain maximum effect.