Prevalence, Treatment and Control of Hypertension in a Croatian Endemic Nephropathy Area

Abstract

Background: Hypertension is not considered to be a characteristic of endemic nephropathy (EN). Recent observations suggested that it might be more prevalent than it was reported before. Aim: The aim of our study was to analyze prevalence, treatment and control of hypertension in a Croatian endemic area. Methods: In the present cross-sectional study, 1,602 farmers were enrolled, 1,246 from EN and 356 from control villages. Epidemiological and medical histories were taken and clinical and laboratory examinations performed for kidney function. Blood pressure was measured following the ESH/ESC guidelines. Results: The prevalence of hypertension in EN villages was higher than in control (50.8 vs. 46.5%, p = 0.005). There was no difference in overall treatment, control of all and treated hypertensives between the villages. In all villages, women were treated more than men (EN 41.6 vs. 28.4%, p < 0.001; control 46.4 vs. 27.3%, p < 0.001), but better control of treated was achieved in men (EN 24.7 vs. 17.4%, p = 0.002; control 29.6 vs. 15.5%, p = 0.002). Women had lower income and level of education than men (p < 0.01). Conclusion: Hypertension is highly prevalent in endemic villages. In all villages, men had better blood pressure control despite being treated less. This finding could be explained by poorer education and income in women.

Chronic Kidney Disease of Undetermined Etiology around the World

“…While infections may cause a single episode of AKI, there is no current evidence suggesting a risk of increased progression to CKD. Finally, contaminated food or herbal remedies containing aristolochic acid are considered the likely cause of endemic tubulointerstitial nephritis, hypertension, and urothelial cancer in the Balkan region [35]. Nevertheless, the clinical features (including the lack of increased incidence of urothelial neoplasms), predilection of male gender, and the widespread distribution of the disease make it unlikely that aristolochic acid is the primary cause of MeN.…”