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 TINE de Backer DEINUM Jaap DELMOTTE Philippe DOROBANTU Maria DOUMAS Michalis DUSING Rainer DULY-BOUHANICK Beatrice FAUVEL Jean-Pierre FESLER Pierre GACIONG Zbigniew GKALIAGKOUSI Eugenia GORDIN Daniel GRASSI Guido GRASSOS Charalampos GUERROT Dominique HUART Justine IZZO Raffaele AGUILA Fernando Jaen JARAI Zoltan KAHAN Thomas KANTOLA Ilkka KOCIANOVA 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 PAIXAO-DIAS Vitor PAPADAKIS Ioannis PAPADOPOULOS Dimitris PERL Sabine POLONIA Jorge PONTREMOLI Roberto PUCCI Giacomo ROBLES Nicolas Roberto RUBIN Sebastien RUILOPE Luis Miguel RUMP Lars Christian SAEED Sahrai SANIDAS Elias SARZANI Riccardo SCHMIEDER Roland SILHOL Francois SOKOLOVIC Sekib SOLBU Marit SOUČEK Miroslav STERGIOU George SUDANO Isabella TABBALAT Ramzi TENGIZ Istemihan TRIANTAFYLLIDI Helen TSIOUFIS Konstontinos VACLAVIK Jan MARKUS van der Giet PATRICIA Van der Niepen 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
Year of publication	2024
Type	Article in Periodical
Magazine / Source	Journal of Hypertension
MU Faculty or unit	Faculty of Medicine
Citation
Web	https://journals.lww.com/jhypertension/abstract/2024/09000/screening_and_management_of_hypertensive_patients.12.aspx
Doi	http://dx.doi.org/10.1097/HJH.0000000000003756
Keywords	albuminuria; chronic kidney disease; glomerular filtration rate; hypertension; management; screening
Description	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: 1550%) 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% [1030%] 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.