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In a prespecified analysis of the FLOW trial, the use of an SGLT2 inhibitor did not impact the overall benefits of semaglutide on kidney and cardiovascular outcomes in participants with type 2 diabetes and chronic kidney disease.

The effects of SGLT2 inhibitors on lowering blood pressure are well characterized, but data now demonstrate their enhanced blood pressure-lowering capacity when combined with dual antihypertensive therapy. Specifically, blood pressure was markedly reduced when dapagliflozin was administered to patients receiving a renin–angiotensin system blocker plus a calcium antagonist or β-blocker.

Despite the many advances in understanding and treating diabetes mellitus and diabetes-related kidney disease, progression of nephropathy, which ultimately leads to end-stage kidney disease, remains unstoppable. In the FIELD study, Davis et al. assert that long-term fenofibrate treatment in patients with type 2 diabetes mellitus might resolve this problem.

Resistant hypertension is defined as failure to reach goal blood pressure in patients who are compliant with maximal doses of three antihypertensive drugs, one of which is a diuretic. Despite improvements in controlling blood pressure in the past decade, studies show the prevalence of resistant hypertension is increasing. In this Review, the authors define resistant hypertension and discuss current data on its prevalence, associated comorbidities and prognostic implications.

Many noninsulin glucose-lowering agents have pharmokinetic and elimination profiles that preclude their use in patients with reduced renal function. However, several of these drugs can be used safely in patients on dialysis and should be considered by physicians. In this Review, the authors provide a guide to the use of noninsulin hypoglycaemic agents for the management of diabetes in patients receiving dialysis and also discuss the monitoring of glycaemic control in these patients.

Current guidelines recommend lowering blood pressure (BP) in patients with chronic kidney disease and hypertension. However, a new study suggests that achieving ideal systolic BP targets at the expense of low diastolic BP <70 mmHg is not advantageous for outcomes.

The results of several hypertension studies published in 2011 have contributed to our knowledge on the risks of and treatment for this condition, including the effects of slow-wave sleep, nocturnal dosing of medication, variability in post-stroke blood-pressure reduction, and the impacts of a low-sodium diet.

Renal denervation for the treatment of resistant hypertension is approved in Europe and is being studied in the USA. A newly published ESC consensus document integrates all the published data on this procedure, and summarizes how best to define, evaluate, and follow up patients who are candidates for the procedure.

Hypertension is a chronic disease that can lead to the development of chronic kidney disease (CKD) or exist as a comorbidity of CKD, and can contribute to disease progression. In this Review, Udani and colleagues discuss the pathogenesis, prevalence and epidemiology of hypertension associated with CKD. Major factors in the diagnosis and treatment of CKD-associated hypertension are also described.

Strategies for the management of hypertension in patients with type 2 diabetes mellitus are controversial. New data from a landmark meta-analysis support the use of antihypertensive therapy in these patients but the impact of blood pressure-lowering on albuminuria and progression of chronic kidney disease remains unclear.

Between 20% and 40% of patients with diabetes ultimately develop nephropathy. The bank of data on the multiple and complex mechanisms, disease markers and disease progression continues to grow. This article provides an overview of the current status of findings relating to underlying mechanisms and genetic susceptibility.

World Kidney Day 2009 was celebrated last month in more than 100 countries, and aimed to raise awareness that the symbiotic relationship between hypertension and kidney disease should be prevented.

Chronic kidney disease (CKD) is an established independent risk factor for increased cardiovascular events and cardiovascular mortality. During 2014, several research efforts focused on clarifying the complex pathophysiology, assessing the prognostic associations and improving the treatment of cardiovascular disease in patients with CKD.

Blood pressure lowering slows the progression of diabetic nephropathy whereas the effects of glycaemic control are smaller and slower. New findings from the EMA-REG OUTCOME investigators indicate that SGLT2 inhibition slows the progression of kidney disease by lowering glucose and blood pressure, thereby lowering the risk of adverse renal outcomes in this patient group.

Systemic arterial hypertension is the most important risk factor for morbidity and mortality worldwide and the most common modifiable risk factor for cardiovascular disease. It is important to assess a person's predicted cardiovascular risk in addition to the level of blood pressure in making treatment decisions.

Many considered the failure of the SYMPLICITY HTN-3 trial to represent the end of therapeutic renal denervation. However, promising preliminary data from the SPYRAL HTN-OFF MED study and more recently the SPYRAL HTN-ON MED and RADIANCE-HTN SOLO studies support the efficacy of this intervention for blood pressure lowering in patients with hypertension.

Novel non-steroidal mineralocorticoid receptor antagonists have a better safety profile than steroidal formulations. This Review examines the pro-inflammatory and profibrotic activity of mineralocorticoid receptor activation and discusses the therapeutic potential of MRAs in the treatment of diabetic kidney disease to improve kidney and cardiovascular outcomes.