Renal consequences of arterial hypertension

Ruilope, Luis; Alcázar, Jose María Morillas; Rodicio, José L.

doi:10.1097/00004872-199212000-00010

Cited by 34 publications

(22 citation statements)

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“…In 500 untreated hypertensive patients followed until death, Perera (20) described that proteinuria was present in 42% and chronic renal failure in 18%. Growing evidence indicates that renal prognosis is not so good in either hypertensive patients or the general population (4,(7)(8)(9)(10)(11)(12). The Heart Outcomes Prevention Evaluation (HOPE) study showed a prevalence of CKD of 10.4% according to serum creatinine values Ͼ 1.4 mg/dl (21).…”

Section: Discussionmentioning

confidence: 99%

“…In fact, high levels of treated BP are positively and significantly related to early decline in kidney function among hypertensive men (2), and hypertensive nephrosclerosis is recognized as a major cause of ESRD (3,4). The prevalence of chronic kidney disease (CKD) in essential hypertension has been considered to be low (Ͻ2%) on the basis of serum creatinine concentration as the index to estimate renal function (5,6).…”

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confidence: 99%

“…The prevalence of chronic kidney disease (CKD) in essential hypertension has been considered to be low (Ͻ2%) on the basis of serum creatinine concentration as the index to estimate renal function (5,6). However, other evidences indicate that renal prognosis is not so benign in hypertensive patients (4,(7)(8)(9) and that CKD is more prevalent than previously expected in treated essential hypertension (10 -12). Evaluation of renal function in long-term treated hypertensive patients has two main difficulties: first, the slow rate of progression to ESRD of nephrosclerosis, requiring very long follow-ups to investigate the evolution of renal function (4); second, the low discriminatory capacity of serum creatinine levels as an indicator of the renal filtration capacity and its changes with time (13,14).…”

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confidence: 99%

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Development Of Chronic Kidney Disease and Cardiovascular Prognosis in Essential Hypertensive Patients

Segura¹,

Campo²,

Gil³

et al. 2004

Journal of the American Society of Nephrology

101

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Abstract. The existence of a significant percentage of treated hypertensive patients presenting a diminished renal function has been recently described. Mild renal function abnormalities are recognized as powerful predictors of cardiovascular morbidity and mortality. However, longitudinal data demonstrating this association are lacking. The objectives of this study have been analysis of the evolution of GFR, assessed as creatinine clearance (CrCl), during long-term follow-up of hypertensive patients and evaluation of the impact of the development of chronic kidney disease (CKD) on cardiovascular prognosis. A historical cohort of 281 patients attending our Hypertension Unit was selected according to the following criteria: essential hypertension, more than 5 yr of follow-up, and normal GFR at baseline (CrCl Ͼ 90 ml/min per 1.73 m 2 ). Patients had an average follow-up of 13.2 Ϯ 4.8 yr. Forty-one patients (14.6%) developed CKD (CrCl Ͻ 60 ml/min per 1.73 m 2 ) attributed to hypertensive nephrosclerosis. Initial serum creatinine, age, systolic BP at baseline, and average total cholesterol during follow-up were independent predictors of CKD development. Forty-nine (17.4%) of 281 patients presented a cardiovascular event during follow-up: 17 patients (40.6%) who developed CKD and 32 patients (13.3%) with preserved renal function (log rank test P Ͻ 0.001). After adjustment in a Cox multivariate analysis, age, development of CKD during follow-up, and male gender were independent predictors of the appearance of cardiovascular events. In essential hypertensive patients with normal renal function at baseline, the development of CKD during the follow-up is strongly and independently related with poor cardiovascular prognosis.The relation between elevated BP and end-stage renal disease (ESRD) is well established (1). In fact, high levels of treated BP are positively and significantly related to early decline in kidney function among hypertensive men (2), and hypertensive nephrosclerosis is recognized as a major cause of ESRD (3,4). The prevalence of chronic kidney disease (CKD) in essential hypertension has been considered to be low (Ͻ2%) on the basis of serum creatinine concentration as the index to estimate renal function (5,6). However, other evidences indicate that renal prognosis is not so benign in hypertensive patients (4,7-9) and that CKD is more prevalent than previously expected in treated essential hypertension (10 -12). Evaluation of renal function in long-term treated hypertensive patients has two main difficulties: first, the slow rate of progression to ESRD of nephrosclerosis, requiring very long follow-ups to investigate the evolution of renal function (4); second, the low discriminatory capacity of serum creatinine levels as an indicator of the renal filtration capacity and its changes with time (13,14). GFR is the best measure of overall renal function in health and disease (14). In clinical practice, measurement of creatinine clearance with 24-h urine collection is considered as an adequate estimate of GFR...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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confidence: 99%

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Development Of Chronic Kidney Disease and Cardiovascular Prognosis in Essential Hypertensive Patients

Segura¹,

Campo²,

Gil³

et al. 2004

Journal of the American Society of Nephrology

101

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“…1 Further, this association portends an ominous prognosis. Patients with HT and CKD are at a much greater risk for cardiovascular disease as compared with those without chronic kidney disease.…”

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confidence: 99%

Hypertension-Chronic Kidney Disease Relationships

Berbari¹,

Daouk²

2017

Nephrol Open J

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“…In some studies patients treated with diuretics or beta-blockers showed a prevalence of 25%, while others have described a prevalence of proteinuria in a range of 4 to 16% (12,13). The degree of microalbuminuria was positively correlated with office blood pressure although better correlations have been observed using 24-h ambulatory monitoring.…”

Section: Introductionmentioning

confidence: 99%

Relationship between microalbuminuria and cardiac structural changes in mild hypertensive patients

Plavnik

Silva

Kohlmann

et al. 2002

Braz J Med Biol Res

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The aim of this study was to determine the relationship between urinary albumin excretion (UAE), cardiac structural changes upon echocardiography and 24-h ambulatory blood pressure (ABPM) levels. Twenty mild hypertensive patients (mean age 56.8 ± 9.6 years) were evaluated. After 2 weeks of a washout period of all antihypertensive drugs, all patients underwent an echocardiographic evaluation, a 24-h ABPM and an overnight urine collection. Systolic and diastolic blood pressure during 24-h ABPM was 145 ± 14/91 ± 10 mmHg (daytime) and 130 ± 14/76 ± 8 mmHg (nighttime), respectively. Seven (35%) patients presented UAE ≥15 µg/min, and for the whole group, the geometric mean value for UAE was 10.2 x/÷ 3.86 µg/min. Cardiac measurements showed mean values of interventricular septum thickness (IVS) of 11 ± 2.3 mm, left ventricular posterior wall thickness (PWT) of 10 ± 2.0 mm, left ventricular mass (LVM) of 165 ± 52 g, and left ventricular mass index (LVMI) of 99 ± 31 g/m 2 . A forward stepwise regression model indicated that blood pressure levels did not influence UAE. Significant correlations were observed between UAE and cardiac structural parameters such as IVS (r = 0.71, P<0.001), PWT (r = 0.64, P<0.005), LVM (r = 0.65, P<0.005) and LVMI (r = 0.57, P<0.01). Compared with normoalbuminuric patients, those who had microalbuminuria presented higher values of all cardiac parameters measured. The predictive positive and negative values of UAE ≥15 µg/min for the presence of geometric cardiac abnormalities were 75 and 91.6%. These data indicate that microalbuminuria in essential hypertension represents an early marker of cardiac structural damage.

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Renal consequences of arterial hypertension

Cited by 34 publications

References 0 publications

Development Of Chronic Kidney Disease and Cardiovascular Prognosis in Essential Hypertensive Patients

Development Of Chronic Kidney Disease and Cardiovascular Prognosis in Essential Hypertensive Patients

Hypertension-Chronic Kidney Disease Relationships

Relationship between microalbuminuria and cardiac structural changes in mild hypertensive patients

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