IMPORTANCE OF BLOOD-PRESSURE CONTROL IN THE PRESERVATION OF RENAL-FUNCTION

End-stage renal disease has become a major and costly public health pr oblem owing primarily to an accelerating incidence of renal failure fr om hypertension and diabetes. In both disease groups the primary probl em appears to be persistent elevation of blood pressure, and there is evidence that early and effective blood pressure control arrests the r enal damage and provides continuing protection to the kidney. It is re commended that the blood pressure be controlled to levels below 150/95 mm Hg for essential hypertension and below 140/85 mm Hg for the hyper tensive diabetic. Serial monitoring of renal function can be done with a graph of reciprocal (1/serum creatinine) values of annual serum cre atine measurements, particularly in groups at increased risk for end-s tage renal disease. High-risk groups include blacks, older individuals , and those with serum creatinine levels greater than or equal to 1.5 mu g/dL.