A1 Refereed original research article in a scientific journal
Screening and management of hypertensive patients with chronic kidney disease referred to Hypertension Excellence Centres among 27 countries. A pilot survey based on questionnaire
Authors: Halimi Jean-Michel, Sarafidis Pantelis, Azizi Michel, Bilo Grzegorz, Burkard Thilo, Bursztyn Michael, Camafort Miguel, Chapman Neil, Cottone Santina, de Backer Tine, Deinum Jaap, Delmotte Philippe, Dorobantu Maria, Doumas Michalis, Dusing Rainer, Duly-Bouhanick Béatrice, Fauvel Jean-Pierre, Fesler Pierre, Gaciong Zbigniew, Gkaliagkousi Eugenia, Gordin Daniel, Grassi Guido, Grassos Charalampos, Guerrot Dominique, Huart Justine, Izzo Raffaele, Águila Fernando Jaén, Járai Zoltán, Kahan Thomas, Kantola Ilkka, Kociánová 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, Paixão-Dias Vitor, Papadakis Ioannis, Papadopoulos Dimitris, Perl Sabine, Polónia Jorge, Pontremoli Roberto, Pucci Giacomo, Robles Nicolás Roberto, Rubin Sébastien, Ruilope Luis Miguel, Rump Lars Christian, Saeed Sahrai, Sanidas Elias, Sarzani Riccardo, Schmieder Roland, Silhol François, Sokolovic Sekib, Solbu Marit, Soucek Miroslav, Stergiou George, Sudano Isabella, Tabbalat Ramzi, Tengiz Istemihan, Triantafyllidi Helen, Tsioufis Konstontinos, Václavík Jan, van der Giet Markus, Van der Niepen Patricia, Veglio Franco, Venzin Reto M., Viigimaa Margus, Weber Thomas, Widimsky Jiri, Wuerzner Grégoire, Zelveian Parounak, Zebekakis Pantelis, Lueders Stephan, Persu Alexandre, Kreutz Reinhold, Vogt Liffert; European Society of Hypertension Working Group on Hypertension, the Kidney
Publisher: Lippincott
Publication year: 2024
Journal: Journal of Hypertension
Journal name in source: Journal of hypertension
Journal acronym: J Hypertens
Volume: 42
Issue: 9
First page : 1544
Last page: 1554
ISSN: 0263-6352
eISSN: 1473-5598
DOI: https://doi.org/10.1097/HJH.0000000000003756
Web address : https://journals.lww.com/jhypertension/fulltext/9900/screening_and_management_of_hypertensive_patients.468.aspx
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: 15-50%) 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% [10-30%] 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.
Funding information in the publication:
The Survey was conducted through an unrestricted educational grant from AstraZeneca. The sponsor has had no involvement with the analyses and the development of the manuscript.
