Hypertension is both a cause and a consequence of chronic kidney disease (CKD), creating a bidirectional relationship that exacerbates cardiovascular and renal complications. The pathophysiology of hypertension in CKD is multifaceted, involving deregulation of the renin-angiotensin-aldosterone system (RAAS), endothelial dysfunction, volume overload, and increased arterial stiffness. Additionally, uremic toxins and oxidative stress further amplify vascular injury and inflammation, contributing to the progression of both hypertension and renal impairment. Traditional antihypertensive therapies, including RAAS inhibitors, calcium channel blockers, and diuretics, remain central to management; however, therapeutic challenges persist due to CKD-associated pharmacokinetic alterations and patient heterogeneity. Recent advancements in treatment approaches have introduced novel pharmacological and non-pharmacological interventions. These include using sodium-glucose cotransporter-2 (SGLT2) inhibitors, which have demonstrated Renoprotective and blood-pressure-lowering effects, and non-steroidal mineralocorticoid receptor antagonists, offering improved safety profiles. Emerging technologies such as renal denervation and baroreceptor activation therapy provide innovative, non-invasive options for resistant hypertension. Additionally, personalized medicine approaches, including genomics and biomarker-based risk stratification, hold promise for tailoring interventions to individual patient profiles. This review highlights the intricate interplay between hypertension and CKD pathophysiology, discusses recent advancements in therapeutic strategies, and underscores the need for a multidisciplinary approach to optimize patient outcomes. By integrating cutting-edge research with clinical practice, future strategy can mitigate the dual burden of hypertension and CKD, reducing morbidity and mortality in affected populations.
Background: Spacing in the midline of the natural dentition has long been a focus for Prosthodontists. The challenge often proves difficult, with the common approach being to incorporate the gap into the treatment plan, rather than attempting to eliminate it entirely. This is due to the fact that closing a midline diastema with a fixed prosthesis frequently leads to aesthetic compromises.
Case Presentation: In this article, 2 cases with excessive space in the anterior region are discussed. The prosthetic rehabilitation was done by using a modified FPD with loop connectors instead of a conventional FPD design. Using this method to restore patients’ natural smiles helped boost confidence and patient satisfaction.
Conclusion: Replacing a single anterior tooth is a complex and demanding procedure that can be successfully achieved using implant-supported restorations, conventional porcelain-fused-to-metal crowns, or resin-bonded fixed partial dentures. A range of aesthetic treatment options should be carefully considered when planning the best approach for such patients.
