engleski

Unrecognized chronic kidney disease (1.-4. stage) in patients with hypertension

The link between the arterial hypertension (AH) and kidney has been considered a villain-victim relationship. AH is one of the two most important causes of chronic kidney disease (CKD) in the developed world. We investigated what proportions of patients with AH have unrecognized CKD (1-4 stage). Prevalence rates of albuminuria (defined as albumin/creatinin ratio over 3.5 mg/mmol) as an early marker of CKD was investigated among 60 ambulatory non-diabetic hypertensive patients (age 65±24 years, M:F=27:33). AH was defined as blood pressure ≥ 140/90 mmHg. The most used antihypertensive were combination of angiotensin-converting enzyme inhibitors (ACEI) with diuretics and calcium channel blockers (CCB) or angiotensin II receptor blockers (ARB) with diuretics and CCB. Estimated glomerular filtration rate (eGFR) was calculated using Cockroft-Gault formula and Modification of Diet in Renal Disease (MDRD) formula. Clinical and laboratory data of 60 patients were included in the analysis. AH was controlled in 35% of patients. Majority of studied patients (76%) were normoalbuminuric (albumin/creatinin ratio <3.5 mg/mmol), and albuminuria was present in 24% of patients. The prevalence of CKD was 31% and 39%, according to Cockroft-Gault formula and MDRD formula. Multivariate logistic regression analysis revealed that male sex, systolic blood pressure and eGFR were factors significantly associated with the presence of albuminuria. AH and CKD affects a large proportion of world population. In this study of 60 ambulatory non-diabetic hypertensive patients we have documented that significant proportion of patients with hypertension have unrecognized CKD. Blood pressure control below 130/80 mmHg in this patients plays a key factor in reducing risk of renal disease progression.

hypertension; chronic kidney disease

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