Title of article :
Changes in Kidney Function in a Population With Essential Hypertension in Real Life Settings
Author/Authors :
Ptinopoulou, Anastasia G Glasgow Renal and Transplant Unit - Queen Elizabeth University Hospital, Glasgow, UK , Pikilidou, Maria I Hypertension Excellence Center - First Department of Internal Medicine - AHEPA University Hospital - Aristotle University of Thessaloniki, Greece , Tziolas, Ioannis M Hypertension Excellence Center - First Department of Internal Medicine - AHEPA University Hospital - Aristotle University of Thessaloniki, Greece , Haidich, Anna-Bettina Department of Hygiene and Epidemiology - School of Medicine - Aristotle University of Thessaloniki, Greece , Mark, Patrick B Institute of Cardiovascular and Medical Sciences - College of Medical - Veterinary and Life Sciences - University of Glasgow, Glasgow, UK , Zebekakis, Pantelis E Hypertension Excellence Center - First Department of Internal Medicine - AHEPA University Hospital - Aristotle University of Thessaloniki, Greece , Lasaridis, Anastasios N Hypertension Excellence Center - First Department of Internal Medicine - AHEPA University Hospital - Aristotle University of Thessaloniki, Greece
Abstract :
Introduction. Hypertension has been identified as one of the
commonest modifiable determinants for chronic kidney disease
progression. A variety of antihypertensive drugs are available and
their effect on kidney function has been investigated by a large
number of randomized controlled trials. Observational studies,
although scarcely been used, outpatient can reflect everyday
practice, where drug exposures vary over time, and may provide
an alternative for detecting longitudinal changes in kidney function.
Materials and Methods. We applied mixed model repeated measures
analysis to investigate the effect of antihypertensive drug categories
and their combinations on kidney function change over time in a
cohort of 779 patients with essential hypertension, using the data
from a Greek hypertension outpatient clinic. Antihypertensive
drugs were grouped in 5 categories. Their effect was evaluated
and their combinations with and without renin-angiotensin-system
inhibitors (RASI) to each other. In addition, the combination of
RASI with calcium channel blockers (CCBs) was studied.
Results. Diuretics, RASI, CCBs, and beta-blockers had a significant
renoprotective and blood pressure lowering effect. Combinations
with RASI had a smaller beneficial effect on kidney function
compared to CCBs (0.75 mL/min/1.73 m2 per year of drug use
versus 0.97 mL/min/1.73 m2). There was no additional effect
when combining RASI with CCBs. However, the lowering effect
on systolic blood pressure was greater (-0.83 mm Hg per year of
drug use, P < .001).
Conclusions. RASI were found to have a smaller, although
significant, renoprotective effect. There was no additional effect
on kidney function when combining RASI with CCBs.
Keywords :
outpatient clinic , mixed effects model , repeated measures analysis , chronic kidney disease , blood pressure , antihypertensive drugs
Journal title :
Iranian Journal of Kidney Diseases (IJKD)
