Screening and management of hypertensive patients with chronic kidney disease referred to Hypertension Excellence Centres among 27 countries. A pilot survey based on questionnaire.
J Hypertens
; 42(9): 1544-1554, 2024 Sep 01.
Article
em En
| MEDLINE
| ID: mdl-38747416
ABSTRACT
OBJECTIVE:
Real-life management of hypertensive patients with chronic kidney disease (CKD) is unclear.METHODS:
A survey was conducted in 2023 by the European Society of Hypertension (ESH) to assess management of CKD patients referred to ESH-Hypertension Excellence Centres (ESH-ECs) at first referral visit. The questionnaire contained 64 questions with which ESH-ECs representatives were asked to estimate preexisting CKD management quality.RESULTS:
Overall, 88 ESH-ECs from 27 countries participated (fully completed surveys 66/88 [75.0%]). ESH-ECs reported that 28% (median, interquartile range 15-50%) had preexisting CKD, with 10% of them (5-30%) previously referred to a nephrologist, while 30% (15-40%) had resistant hypertension. The reported rate of previous recent (<6âmonths) estimated glomerular filtration rate (eGFR) and urine albumin-creatinine ratio (UACR) testing were 80% (50-95%) and 30% (15-50%), respectively. The reported use of renin-angiotensin system blockers was 80% (70-90%). When a nephrologist was part of the ESH-EC teams the reported rates SGLT2 inhibitors (27.5% [20-40%] vs. 15% [10-25], P â=â0.003), GLP1-RA (10% [10-20%] vs. 5% [5-10%], P â=â0.003) and mineralocorticoid receptor antagonists (20% [10-30%] vs. 15% [10-20%], P â=â0.05) use were greater as compared to ESH-ECs without nephrologist participation. The rate of reported resistant hypertension, recent eGFR and UACR results and management of CKD patients prior to referral varied widely across countries.CONCLUSIONS:
Our estimation indicates deficits regarding CKD screening, use of nephroprotective drugs and referral to nephrologists before referral to ESH-ECs but results varied widely across countries. This information can be used to build specific programs to improve care in hypertensives with CKD.
Texto completo:
1
Coleções:
01-internacional
Temas:
Geral
Base de dados:
MEDLINE
Assunto principal:
Insuficiência Renal Crônica
/
Hipertensão
Limite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
J Hypertens
/
J. hypertens
/
Journal of hypertension
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
França