Key result
Rapid eGFR decline affects ~11 per 100 person-years in hypertensives, linked to diabetes and uncontrolled hypertension.
Why the study?
The causes of rapid decline in kidney function in the early stage or preserved function of hypertension-related kidney disease are less evident.
Cohort (n=1,328)
No
Among hypertensive patients with preserved kidney function, the incidence of rapid eGFR decline was 11.1 per 100 person-years, driven significantly by older age, diabetes, and uncontrolled blood pressure.
Signals notable rapid eGFR decline risk in hypertensives; leaves open whether targeting age, diabetes, and BP alters trajectories.
Background: Hypertension is the second most common leading cause of chronic kidney disease. Related studies explored the causes of the rapid decline of kidney function in advanced kidney disease. However, the causes of the rapid decline of kidney function in the early stage or preserved function of hypertensionrelated kidney disease are less evident. Objectives: The study aimed to identify the incidence and associated risk factors for the decline of the glomerular filtration rate (GFR) among patients with hypertension with preserved kidney function, estimated GFR (eGFR) above 60/mL/min/1.73m2, at a community hospital. Methods: A retrospective cohort study was conducted among patients with hypertension with 2 eGFR measures at least 1 year apart and were identified from all cases attending at the Outpatient Department, Sanam Chai Khet Hospital, Chachoengsao Province. The incidence of the estimated rate of eGFR decline greater than 5 mL/min/1.73m2 yearly (ERGFR5/yr) was determined. In addition, potential risk and protective factors were identified using Poisson Regression. Results: Of 1,328 patients with hypertension, 53.05% were females. The mean age was 59.68 ± 11.58 years. The mean GFR measure at the 1st visit was 88.71± 14.73 mL/min/1.73m2. The incidence of ERGFR5/yr was 11.1 (95% CI: 10.1-12.3)) per 100-person year. Risk factors were being 60 years or older with an incidence rate ratio (IRR) of 1.4 (95% CI: 1.11-1.77), having diabetes mellitus with an IRR of 1.67 (95% CI: 1.37-2.04) and uncontrolled hypertension with an IRR of 1.15 (95% CI: 1.10-1.20). Conclusion: The incidence of ERGFR5/yr among renal preserved patients with hypertension was relatively low compared with other studies. Aggressive intervention among patients with comorbidity could reduce the incidence of rapid decline in eGFR.
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Thiannitiworakun et al. (2023) conducted a cohort in Hypertension with preserved kidney function (n=1,328). Risk factors (age ≥60, diabetes, uncontrolled hypertension) was evaluated on Estimated rate of eGFR decline greater than 5 mL/min/1.73m2 yearly (ERGFR5/yr) (95% CI 10.1-12.3). Among hypertensive patients with preserved kidney function, the incidence of rapid eGFR decline was 11.1 per 100 person-years, with age ≥60, diabetes, and uncontrolled hypertension as key risk factors.
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