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Features of arterial hypertension combined with chronic kidney disease when using different types of drug correction of high blood pressure

Written by Solyanik E.V., Shevchenko E.I., Kim A.Y., Yakuhnaya E.V.

  UDK: 616.12–008.331.1–06:616.61–002.2–085 | DOI: 10.17238/PmJ1609-1175.2019.1.29–32  Pages: 29–32 | Full text PDF | Open PDF 

Annotation:

Objective: The study objective is to analyze the population features of arterial hypertension (AH) combined with chronic kidney disease (CKD) with the assessment of pharmacological and epidemiological aspects of antihypertensive therapy (AHT).
Methods: Prospective study including questionnaire survey of 443 patients with diagnosed AH from different locations of Primorskiy territory. Average age of patients is 56.5. The stage of renal dysfunction was determined with the calculation formula of glomerular filtration rate (GFR) according to CKD-EPI. To evaluate results we used Rewiew Manager 5.3.
Results: CKD of different severity was detected in all surveys. 391 patients (88.3 %) showed a decline of GFR of 2–5 stages. Stages 2 and 3a were detected most frequently – in 316 patients (71.3 % of the total number). Comparison between physicians’ adherence to therapy of AH in the study PIFAGOR IV and in this work did not show any significant differences. Some regional features of cardioreal interactions in patients with AH were identified, in particular, a higher level of CKD 2 and 3a stages and a lower prevalence of minor renal dysfunction were determined. The priority combinations of AHT were combinations of inhibitors of angiotensin transforming enzyme and diuretic, angiotensin-2 receptor antagonist and diuretic; beta-adrenergic blocking agent were used most rarely.
Conclusions: Regional features of AH include a higher prevalence of CKD of late stages and caused by differences in average age of patients and by climatic, social and demographical factors. Clinical practice of drug therapy of patients with AH combined with CKD meets common standards both in drug choice and dosing schedule. Diagnosis of CKD by the level of creatinine in the biochemical blood test using certain formulas and calculators and the correction of treatment regimens based on renal dysfunction increases the antihypertensive efficacy of drug treatment and has a nephroprotective effect.

Links to authors:

E.V. Solyanik, E.I. Shevchenko, A.Y. Kim, E.V. Yakuhnaya
Pacific State Medical University (2 Ostryakova Ave. Vladivostok 690002 Russian Federation)


1. Arterial hypertension in adults: Clinical guidelines. Moscow: Russian Medical Society for Arterial Hypertension, 2016. 70 p.
2. Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Grope. KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease // Kidney inter., Suppl. 2013. Vol. 3. P. 1–150.
3. Leonova M.V., Belousov Yu.B., Steinberg L.L. [et al.]. The results of pharmacoepidemiologic study PIFAGOR IV concerning arterial hypertension // Systemic hypertension. 2015. Vol. 12, No. 3. P. 11–18.
4. Nagaitseva S.S., Shvetsov M.Y., Shalyagin Y.D. Risk factors for elevation of albuminuria as an early marker of chronic kidney disease in different age groups. // Nephrology. 2013. No. 4. P. 58–62.
5. Oshchepkova E.V., Dolgusheva Yu.A., Zhernakova Yu.V. [et al.]. The prevalence of renal dysfunction in arterial hypertension (in the framework of the ESSE-RF study) // Systemic Hypertension. 2015. Vol. 12, No. 3. P. 19–24.
6. The prevalence of non-infectious diseases risk factors in russian population in 2012–2013 years. The results of ECVD-RF // Cardiovascular Therapy and Prevention. 2014. Vol. 13, No. 6. P. 4–11.
7. Solyanik E.V., Eliseeva E.V., Geltser B.I. [et al.]. Pharmacoepidemiological analysis of the consumption of organic nitrates in medical institutions of outpatient and inpatient type // Problems of Standardization in Health Care. 2008. No. 10. P. 21–25.
8. Сhazova I.E., Zhernakova Yu.V., Oschepkova E.V. [et al.]. Prevalence of DF of cardiovascular diseases in the Russian population of patients with arterial hypertension // Cardiology. 2014. No. 10. P. 4–12.
9. Crews D.C., Piantinga L.C., Miller E.R. [et al.]. Prevalence of chronic kidney disease in persons with undiagnosed or prehypertension in the United States. // Hypertension. 2010. Vol. 55, No. 5. P. 1102–1109.
10. Klausen K.P., Scharling H., Jensen G. et al. New definition of microalbuminuria in hypertensive subjects: association with incident coronary heart disease and death // Hypertension. 2005. Vol. 46, No. 1. P. 33–37.
11. Ruggenenti P., Fassi A., Ilieva A.P. [et al.]. Preventing microalbuminuria in type 2 diabetes. // The New England Journal of Medicine. 2004. Vol. 319, No. 19. P. 1941–1951.
12. Schmieder R.E., Schrader J., Zidek W. [et al.]. Low-grade albuminuria and cardiovascular risk: what is the evidence? // Clin. Res. Cardiol. 2007. Vol. 96, No. 5. P. 247–257.

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