Renal Dysfunction in Patients With Hypertension

Arterial hypertension (AH) is a major risk factor for chronic kidney disease (CKD). In outpatient practice, early diagnosis of renal complications is crucial for timely therapeutic adjustments. This study evaluates the impact of hypertension duration and the degree of blood pressure control on kidney function in outpatients by analyzing serum creatinine, blood urea nitrogen, albuminuria, and estimated glomerular filtration rate (eGFR). Objective: To investigate the clinical features of hypertension in the development and progression of CKD. Materials and Methods: A retrospective study was conducted at City Polyclinic № 8 in Almaty in 2024, including 104 hypertensive patients aged 45–74 years. Clinical and laboratory parameters, eGFR, albuminuria, and associated risk factors were assessed. Statistical analysis was performed using Microsoft Excel 2016, employing the t-test, odds ratio calculations, and regression analysis. A significance level of p < 0.05 was considered statistically significant. Results: eGFR declined with age: 85.3 ± 16.1 mL/min/1.73 m² in middle-aged patients versus 68.4 ± 19.7 mL/min/1.73 m² in elderly patients (p < 0.001). Albuminuria was detected in 18.5% of middle- aged patients and 37.8% of elderly patients (OR = 3.5; 95% CI: 1.9–6.4; p < 0.001). CKD was identified in 27.9% of patients, predominantly among the elderly. Hypertension duration correlated with eGFR decline: in patients with hypertension ≤5 years, eGFR was 96.0 ± 9.1 and 85.5 ± 10.8 mL/min/1.73 m², whereas in those with hypertension >10 years, it decreased to 68.4 ± 8.9 and 58.8 ± 8.0 mL/min/1.73 m² (p < 0.001). The prevalence of albuminuria increased from 15.4% in patients with hypertension ≤5 years to 47.4% in those with hypertension >10 years (p < 0.01). Among patients with uncontrolled hypertension (>160/>100 mmHg), CKD stage 3 was observed in 32.9%, while CKD stages 4–5 were found in 16.4% (p < 0.001). Key risk factors for renal dysfunction included prolonged hypertension (OR = 2.8; p < 0.01), poor BP control (OR = 3.2; p < 0.001), obesity (OR = 1.57; p = 0.02), and diabetes mellitus (OR = 2.1; p < 0.01). Conclusion: Our study demonstrates that prolonged hypertension, inadequate BP control, obesity, and diabetes mellitus are major risk factors for renal dysfunction. Effective BP management, metabolic disorder correction, and early CKD diagnosis may slow disease progression in hypertensive patients.