Analysis of blood pressure control in outpatients with non-dialysis chronic kidney disease referred by primary care physicians: a study from the centre of nephrology care

Abstract

Background. Patients with chronic kidney disease (CKD) have increased all-cause mortality, especially cardiovascular.
The majority of patients with CKD have stages 1–3 and are treated by primary care physicians and nephrologists.
Arterial hypertension (HTN) is highly prevalent comorbidity among CKD population, but its control remains poor.

Material and methods. This retrospective non-interventional cross-sectional study was conducted in the Centre of
Nephrology Care in Dnipropetrovsk Mechnikov Regional Hospital, Dnipro, Ukraine. We aimed to select patients
who are supposed to be followed-up by primary care practitioners but due to certain reasons required nephrologist’s
consultation. From 4540 patients who received medical care in the Centre of Nephrology Care 365 patients fulfilled
inclusion criteria. They were subdivided by presence of HTN, CKD stage, presence of proteinuria and achieving
blood pressure targets according to different standards. All patients were examined and followed-up according to
local and European standards.

Results. Forty-nine percent of patients had known HTN, and 21% had HTN de novo. Advance of CKD stage was
significantly associated with increase in the most of laboratory findings, age and BP values. Non-proteinuric patients
achieved BP goals significantly more often, than proteinuric ones. Females achieved BP targets more often, than
males. Monotherapy was the most common treatment regimen.

Conclusions. HTN occurs in 70% of patients with CKD and it is controlled in up to 34% of cases. HTN is important
factor of CKD progression and it is closely connected with GFR and proteinuria.