Screening and management of hypertensive patients with chronic kidney disease referred to Hypertension Excellence Centres among 27 countries. A pilot survey based on questionnaire

• Autoři: HALIMI Jean-Michel; SARAFIDIS Pantelis; AZIZI Michel; BILO Grzegorz; BURKARD Thilo; BURSZTYN Michael; CAMAFORT Miguel; CHAPMAN Neil; COTTONE Santina; TINE de Backer; DEINUM Jaap; DELMOTTE Philippe; DOROBANTU Maria; DOUMAS Michalis; DUSING Rainer; DULY-BOUHANICK Beatrice; FAUVEL Jean-Pierre; FESLER Pierre; GACIONG Zbigniew; GKALIAGKOUSI Eugenia; GORDIN Daniel; GRASSI Guido; GRASSOS Charalampos; GUERROT Dominique; HUART Justine; IZZO Raffaele; AGUILA Fernando Jaen; JARAI Zoltan; KAHAN Thomas; KANTOLA Ilkka; KOCIANOVA Eva; LIMBOURG Florian P; LOPEZ-SUBLET Marilucy; MALLAMACI Francesca; MANOLIS Athanasios; MARKETOU Maria; MAYER Gert; MAZZA Alberto; MACINTYRE Iain M; MOURAD Jean-Jacques; MUIESAN Maria Lorenza; NASR Edgar; NILSSON Peter; OLIVERAS Anna; ORMEZZANO Olivier; PAIXAO-DIAS Vitor; PAPADAKIS Ioannis; PAPADOPOULOS Dimitris; PERL Sabine; POLONIA Jorge; PONTREMOLI Roberto; PUCCI Giacomo; ROBLES Nicolas Roberto; RUBIN Sebastien; RUILOPE Luis Miguel; RUMP Lars Christian; SAEED Sahrai; SANIDAS Elias; SARZANI Riccardo; SCHMIEDER Roland; SILHOL Francois; SOKOLOVIC Sekib; SOLBU Marit; SOUČEK Miroslav; STERGIOU George; SUDANO Isabella; TABBALAT Ramzi; TENGIZ Istemihan; TRIANTAFYLLIDI Helen; TSIOUFIS Konstontinos; VACLAVIK Jan; MARKUS van der Giet; PATRICIA Van der Niepen; VEGLIO Franco; VENZIN Reto M; VIIGIMAA Margus; WEBER Thomas; WIDIMSKY Jiri; WUERZNER Gregoire; ZELVEIAN Parounak; ZEBEKAKIS Pantelis; LUEDERS Stephan; PERSU Alexandre; KREUTZ Reinhold; VOGT Liffert
• Rok publikování: 2024
• Druh: Článek v odborném periodiku
• Časopis / Zdroj: Journal of Hypertension
• Fakulta / Pracoviště MU: Lékařská fakulta
• www: https://journals.lww.com/jhypertension/abstract/2024/09000/screening_and_management_of_hypertensive_patients.12.aspx
• Doi: http://dx.doi.org/10.1097/HJH.0000000000003756
• Klíčová slova: albuminuria; chronic kidney disease; glomerular filtration rate; hypertension; management; screening
• Popis: 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: 1550%) 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 (<6 months) 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 = 0.003), GLP1-RA (10% [10- 20%] vs. 5% [5- 10%], P = 0.003) and mineralocorticoid receptor antagonists (20% [1030%] vs. 15% [10- 20%], P = 0.05) 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.