Chronic kidney disease in patients with arterial hypertension: Frequency of its detection in real-life clinical practice
Abstract. Arterial hypertension (AH) is one of the most common diseases of cardiovascular system. AH can be both a cause of chronic kidney disease (CKD) and its consequence. Screening for early stages of CKD among patients with arterial hypertension will not only slow down the rate of decline in kidney function and delay the onset of renal replacement therapy, but also reduce cardiorenal risk and preventable cardiovascular mortality.Bilevich O.A., Viktorova I.A., Chernykh D.A., Bulakhova E.Yu., Shirinskaya N.V.
The aim: to determine the frequency of CKD detection among patients with arterial hypertension observed in a large medical organization in Omsk, to identify areas of ineffectiveness in CKD diagnosis by local doctors.
Material and methods. A one-time retrospective study was performed. It included 90 patients over 18 years of age with proven diagnosis of arterial hypertension who visited the clinic from January 2022 to December 2023. The presence of data in the outpatient card that are markers of CKD was assessed. Glomerular filtration rate was calculated using the 2021 CKD-EPI formula.
Results. CKD was diagnosed in 27% of patients with AH, stage 3 CKD was the most common (54%). However, a higher actual incidence of CKD could be assumed, since in 19% of study participants this disease could not be reliably confirmed or excluded due to the lack of sufficient information on CKD markers in outpatient records (urine test results, creatinine measurement results, kidney imaging). In most cases (70%), local physicians did not calculate the glomerular filtration rate based on creatinine, especially if the creatinine level was within reference values (up to 115 μmol/l). Other areas of ineffectiveness in CKD diagnosing by local physicians were also identified.
Conclusion. The incidence of CKD among AH patients observed in primary care institutions is at least 27%. Despite the fixed criteria and algorithms for CKD diagnosing, it causes difficulties for physicians of primary care institutions.
Keywords
arterial hypertension
chronic kidney disease
dispensary observation
cardiorenal risk
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About the Authors
Olga A. Bilevich, MD, PhD ((Medicine), associate professor, associate professor of the Department of internal medicine propaedeutics, Omsk State Medical University of the Ministry of Healthcare of Russia. Address: 644099, Omsk, 12 Lenina St.E-mail: bilewich@mail.ru
ORCID: https://orcid.org/0000-0003-2583-5648. eLibrary SPIN: 8290-0245
Inna A. Viktorova, MD, Dr. Sci. (Medicine), professor, head of the Department of outpatient therapy and internal medicine, Omsk State Medical University of the Ministry of Healthcare of Russia. Address: 644099, Omsk, 12 Lenina St.
E-mail: vic-inna@mail.ru
ORCID: https://orcid.org/0000-0001-8728-2722. eLibrary SPIN: 5171-5592
Darya A. Chernykh, 6th year student of the Faculty of general medicine, Omsk State Medical University of the Ministry of Healthcare of Russia. Address: 644099, Omsk, 12 Lenina St.
E-mail: dashachernykh13@gmail.com
ORCID: https://orcid.org/0000-0002-4773-5237. eLibrary SPIN: 8851-2886
Elena Yu. Bulakhova, MD, PhD (Medicine), deputy chief physician for outpatient and polyclinic work, cardiologist at City Polyclinic No. 8 (Omsk). Address: 644052, Omsk, 10 Bagrationa St.
E-mail: sab.pro@mail.ru
ORCID: https://orcid.org/0009-0002-7704-9921
Natalya V. Shirinskaya, MD, PhD (Medicine), expert of the Department for regional healthcare and medical activities development, Omsk State Medical University of the Ministry of Healthcare of Russia, deputy director for medical statistics of Medical Information and Analytic Center (Omsk). Address: 644021, Omsk, 219a 8ya Linia St.
E-mail: shirinskaya@bk.ru
ORCID: https://orcid.org/0000-0001-8295-5203. eLibrary SPIN: 3293-3633
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