Background Hypertension is one of the cardiovascular disease (CVD) risk factors and is present in approximately 70-85% of patients with chronic renal failure. Contrast nephropathy is a potentially serious complication of diagnostic coronarography in patients with chronic kidney disease (CKD). The current K/DOQI guidelines advocate creatinine-based equations for estimating GFR to identify patients with potential CKD and to classify them into different stages on the basis of these values.
Material and methods Assessement of prevalence of CKD using estimating GRF according to MDRD, Cockroft-Gault and Jeliffe formulas in 549 normotensive and 588 hypertensive patients with normal serum creatinine undergoing percutaneous coronary interventions due to ischemic heart disease.
Results In the group of normotensives with normal serum creatinine according to Cockcroft-Gault stage 2 CKD i.e. GRF 60-89 ml/min was found in 46.60% and stage 3 CKD i.e. GRF 30-59 ml/min was found in 26.53% of patients. According to MDRD stage 2 was found in 48.64% and stage 3 in 6.46% of patients. According to Jeliffe formula stage 2 was found in 55.27%, stage 3 in 21.3% of patients. In the group of hypertensives according to Cockcroft-Gault stage 2 CKD was found in 47.13%, stage 3 in 20.56% of patients. According to MDRD stage 2 was found in 48.46%, stage 3 - in 7.47% of patients. According to Jeliffe formula stage 2 was found in 53.67%, stage 3 - in 20.56% of patients. Prevalence of CKD was similar between normotensives and hypertensives. Hypertensives were more likely to be dyslipidemic.
Conclusions The prevalence of CKD is high (over 50%) in normotensives and hypertensives undergoing coronarography despite normal creatinine. The risk of contrast nephropathy is enhanced in these patients, therefore GRF should be estimated. It is an inexpensive, reliable and widely available method.