Analysis of ambulatory blood pressure control in patients with non-dialysis chronic kidney disease referred by primary care physicians: study from the center of nephrology care

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 (AH) 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 Center of Nephrology Care in Dnipropetrovsk Mechnikov Regional Hospital, Dnipro, Ukraine. We aimed to select patients that are supposed to be followed-up by primary care practitioners but which due to certain reasons required nephrologist’s consultation. From 4540 patients that received medical care in the Center of Nephrology Care 365 patients fulfilled inclusion criteria. They were subdivided by presence of AH, 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. 49% of patients had known AH, 21% - AH onset. Advance of CKD stage was significantly associated with increase of the most of laboratory findings, age, BP values and estimated pulse wave velocity. 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 regimen. Conclusions. AH occurs in 70% of patients with CKD and it is controlled in up to 34% cases. AH is an important factor of CKD progression and it is closely connected with GFR and proteinuria. Combined therapy should be preferable for treating AH in patients with CKD