Vol 11, No 2 (2007)
Original paper
Published online: 2007-05-18
Hypertension and chronic kidney disease. Results of Program for Early Detection of Chronic Kidney Disease in Poland (PolNef)
Nadciśnienie tętnicze 2007;11(2):114-122.
Abstract
Background Hypertension is closely associated with chronic kidney disease (CKD), and is a main risk factor of progression of CKD. Early detection of CKD allows introducing of the therapy that slows the progression of CKD.
A prevalence of hypertension and effectiveness of its treatment were assessed during accomplishment of Program for Early Detection of Chronic Kidney Disease in Poland (PolNef).
Material and methods In 456 participants of PolNef program (269 F, 187 M) CKD was recognized. Glomerular filtration rate (eGFR) was estimated by MDRD formula. Frequency of hypertension and effectiveness of its treatment, frequency of overweight and obesity, microalbuminuria, and abnormalities in ultrasound examination of urinary system were studied.
Results 68% of CKD population was hypertensive, 21% of them remained without hypotensive medication, and 22% on medication was effectively treated. Kidney insufficiency with eGFR below 60 ml/min/1.73m2 was recognized in 9% of CKD population. 63% of women and 39% of men without hypertension had normal body mass compare to only 19% of people with CKD and hypertension. Microalbuminuria was found in 51% of women and 66% of men with CKD and hypertension. Increased echogenicity of kidney and simple cysts were detected statistically significantly more often in hypertensive.
Conclusions Prevalence of hypertension in CKD population is high, ineffectively treated, mostly using one hypotensive drug. Frequency of microalbuminuria in CKD patients with hypertension exceeds 50%. Screening tests for detection of CKD seems to be necessary among overweight and obese patients, especially while accompanied by hypertension. An ultrasound diagnostic of urinary tract should be performed in hypertensive patients.
Material and methods In 456 participants of PolNef program (269 F, 187 M) CKD was recognized. Glomerular filtration rate (eGFR) was estimated by MDRD formula. Frequency of hypertension and effectiveness of its treatment, frequency of overweight and obesity, microalbuminuria, and abnormalities in ultrasound examination of urinary system were studied.
Results 68% of CKD population was hypertensive, 21% of them remained without hypotensive medication, and 22% on medication was effectively treated. Kidney insufficiency with eGFR below 60 ml/min/1.73m2 was recognized in 9% of CKD population. 63% of women and 39% of men without hypertension had normal body mass compare to only 19% of people with CKD and hypertension. Microalbuminuria was found in 51% of women and 66% of men with CKD and hypertension. Increased echogenicity of kidney and simple cysts were detected statistically significantly more often in hypertensive.
Conclusions Prevalence of hypertension in CKD population is high, ineffectively treated, mostly using one hypotensive drug. Frequency of microalbuminuria in CKD patients with hypertension exceeds 50%. Screening tests for detection of CKD seems to be necessary among overweight and obese patients, especially while accompanied by hypertension. An ultrasound diagnostic of urinary tract should be performed in hypertensive patients.
Keywords: chronic kidney diseasehypertensionmicroalbuminuriaultrasound examination