In CKD G4 or G5, a combination of a thiazide diuretic and a loop diuretic may be considered to obtain adequate diuresis while exerting due caution for possible adverse effects, such as renal deterioration, hyponatremia and hypokalemia. 2. First-line anti-hypertensive drugs for non-diabetic CKD   In non-diabetic A1 category CKD, no convincing selleck chemical evidence exists to demonstrate the superior benefits of ARBs or ACE inhibitors over other classes of anti-hypertensive drugs. A meta-analysis of patient-level data also showed the beneficial effect of ACE-I in slowing the progression of non-diabetic CKD

with higher baseline urinary protein excretion. Furthermore, ARB reduced the incidence of renal events compared with CCB therapy in Japanese high-risk hypertensive patients with G4 category CKD and proteinuria.

Therefore, for non-diabetic A1 category CKD, ARBs, ACE inhibitors, CCBs or diuretics are recommended as preferred anti-hypertensive drugs (Grade B). On the other hand, RAS inhibition has been shown to be particularly beneficial for renoprotection in non-diabetic CKD patients with proteinuria (A2 and A3 categories), and the presence of proteinuria in non-diabetic CKD patients is a rationale for priority of the RAS inhibitors as first-line anti-hypertensive drugs (Grade B). Bibliography 1. Casas JP, et al. Lancet. 2005;366:2026–33. (Level 1)   2. Holtkamp FA. Eur Heart J. 2011;12:1493–9. (Level 2)   3. Ruggenenti P, et al. N Engl J Med. 2004;351:1941–51. (Level 2)   4. Haller H, et al. N Engl J Med. 2011;364:907–17. (Level 2)   5. Bakris GL, et al. Am J Kidney Dis. 2000;36:646–61. (Level 4)   6. Rahman selleck chemicals llc M, et al. Clin J Am Soc Nephrol. 2012;7:989–1002. (Level 4)   7. Jafar TH, et al. Ann Intern Med. 2003;139:244–52. (Level 4)   8. Appel LJ, et al. N Engl J Med. 2010;363:918–29. (Level 4)   9. The GISEN Group

(Gruppo Italiano di Studi Epidemiologici in Nefrologia). Lancet. 1997;349:1857–63. (Level 2)   10. Jafar TH, et al. Ann Intern Med. 2001;135:73–87. (Level 1)   11. Hou FF, et al. N Engl J Med. 2006;354:131–40. (Level 2)   12. Saruta T, et al. Hypertens Res. 2009;32:505–12. (Level 2)   13. Agodoa LY, et al. JAMA. 2001;285:2719–28. (Level 2)   Exoribonuclease 14. Viberti G, et al. Circulation. 2002;106:672–8. (Level 2)   15. The EUCLID Study Group. Lancet. 1997;349:1787–92. (Level 2)   16. Parving HH, et al. N Engl J Med. 2001;345:870–8. (Level 2)   17. Lewis EJ, et al. N Engl J Med. 1993;329:1456–62. (Level 2)   18. Lewis EJ, et al. N Engl J Med. 2001;345:851–60. (Level 2)   19. Brenner BM, et al. N Engl J Med. 2001;345:861–9. (Level 2)   20. Mann JF, et al. Am J Kidney Dis. 2003;42:936–42. (Level 2)   21. Heart Outcomes Prevention Evaluation Study Investigators. Lancet. 2000;355:253–9. (Level 2)   22. Kunz R, et al. Ann Intern Med. 2008;148:30–48. (Level 1)   23. Imai E, et al. {Selleck Anti-cancer Compound Library|Selleck Anticancer Compound Library|Selleck Anti-cancer Compound Library|Selleck Anticancer Compound Library|Selleckchem Anti-cancer Compound Library|Selleckchem Anticancer Compound Library|Selleckchem Anti-cancer Compound Library|Selleckchem Anticancer Compound Library|Anti-cancer Compound Library|Anticancer Compound Library|Anti-cancer Compound Library|Anticancer Compound Library|Anti-cancer Compound Library|Anticancer Compound Library|Anti-cancer Compound Library|Anticancer Compound Library|Anti-cancer Compound Library|Anticancer Compound Library|Anti-cancer Compound Library|Anticancer Compound Library|Anti-cancer Compound Library|Anticancer Compound Library|Anti-cancer Compound Library|Anticancer Compound Library|Anti-cancer Compound Library|Anticancer Compound Library|buy Anti-cancer Compound Library|Anti-cancer Compound Library ic50|Anti-cancer Compound Library price|Anti-cancer Compound Library cost|Anti-cancer Compound Library solubility dmso|Anti-cancer Compound Library purchase|Anti-cancer Compound Library manufacturer|Anti-cancer Compound Library research buy|Anti-cancer Compound Library order|Anti-cancer Compound Library mouse|Anti-cancer Compound Library chemical structure|Anti-cancer Compound Library mw|Anti-cancer Compound Library molecular weight|Anti-cancer Compound Library datasheet|Anti-cancer Compound Library supplier|Anti-cancer Compound Library in vitro|Anti-cancer Compound Library cell line|Anti-cancer Compound Library concentration|Anti-cancer Compound Library nmr|Anti-cancer Compound Library in vivo|Anti-cancer Compound Library clinical trial|Anti-cancer Compound Library cell assay|Anti-cancer Compound Library screening|Anti-cancer Compound Library high throughput|buy Anticancer Compound Library|Anticancer Compound Library ic50|Anticancer Compound Library price|Anticancer Compound Library cost|Anticancer Compound Library solubility dmso|Anticancer Compound Library purchase|Anticancer Compound Library manufacturer|Anticancer Compound Library research buy|Anticancer Compound Library order|Anticancer Compound Library chemical structure|Anticancer Compound Library datasheet|Anticancer Compound Library supplier|Anticancer Compound Library in vitro|Anticancer Compound Library cell line|Anticancer Compound Library concentration|Anticancer Compound Library clinical trial|Anticancer Compound Library cell assay|Anticancer Compound Library screening|Anticancer Compound Library high throughput|Anti-cancer Compound high throughput screening| Diabetologia. 2011;54:2978–86. (Level 2)   24. MacKinnon M, et al. Am J Kidney Dis. 2006;48:8–20. (Level 1)   25. Tobe SW, et al. Circulation. 2011;123:1098–107.