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
Year: 2024
Type: article
Abstract: 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.
DOI: 10.5167/uzh-271178
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, Jaén Águila, Fernando, Járai, Zoltán, Kahan, Thomas, Kantola, Ilkka, et al, Sudano, Isabella
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W6892307310
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