Management of patients with hypertension and chronic kidney disease referred to Hypertension Excellence Centres among 27 countries. On behalf of the European Society of Hypertension Working Group on Hypertension and the Kidney
: 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; Jaén Águila, Fernando; 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; der Niepen, Patricia Van; Veglio, Franco; Venzin, Reto M.; Viigimaa, Margus; Weber, Thomas; Widimsky, Jiri; Wuerzner, Gregoire; Zelveian, Parounak; Zebekakis, Pantelis; Lueders, Stephan; Persu, Alexandre; Kreutz, Reinhold; Vogt, Liffert
Publisher: Taylor & Francis
: 2024
: Blood Pressure
: Blood pressure
: Blood Press
: 2368800
: 33
: 1
: 0803-7051
: 1651-1999
DOI: https://doi.org/10.1080/08037051.2024.2368800
: https://doi.org/10.1080/08037051.2024.2368800
: https://research.utu.fi/converis/portal/detail/Publication/456989181
Objective Real-life management of patients with hypertension and chronic kidney disease (CKD) among European Society of Hypertension Excellence Centres (ESH-ECs) is unclear : we aimed to investigate it. Methods A survey was conducted in 2023. The questionnaire contained 64 questions asking ESH-ECs representatives to estimate how patients with CKD are managed. Results Overall, 88 ESH-ECS representatives from 27 countries participated. According to the responders, renin-angiotensin system (RAS) blockers, calcium-channel blockers and thiazides were often added when these medications were lacking in CKD patients, but physicians were more prone to initiate RAS blockers (90% [interquartile range: 70-95%]) than MRA (20% [10-30%]), SGLT2i (30% [20-50%]) or (GLP1-RA (10% [5-15%]). Despite treatment optimisation, 30% of responders indicated that hypertension remained uncontrolled (30% (15-40%) vs 18% [10%-25%]) in CKD and CKD patients, respectively). Hyperkalemia was the most frequent barrier to initiate RAS blockers, and dosage reduction was considered in 45% of responders when kalaemia was 5.5-5.9 mmol/L. Conclusions RAS blockers are initiated in most ESH-ECS in CKD patients, but MRA and SGLT2i initiations are less frequent. Hyperkalemia was the main barrier for initiation or adequate dosing of RAS blockade, and RAS blockers' dosage reduction was the usual management.
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The Survey was conducted through an unrestricted educational grant from AstraZeneca. The sponsor had no involvement in the analyses and the development of the manuscript.
