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
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Rok publikování | 2024 |
Druh | Článek v odborném periodiku |
Časopis / Zdroj | Blood Pressure |
Fakulta / Pracoviště MU | |
Citace | HALIMI, Jean-Michel; Pantelis SARAFIDIS; Michel AZIZI; Grzegorz BILO; Thilo BURKARD; Michael BURSZTYN; Miguel CAMAFORT; Neil CHAPMAN; Santina COTTONE; de Backer TINE; Jaap DEINUM; Philippe DELMOTTE; Maria DOROBANTU; Michalis DOUMAS; Rainer DUSING; Beatrice DULY-BOUHANICK; Jean-Pierre FAUVEL; Pierre FESLER; Zbigniew GACIONG; Eugenia GKALIAGKOUSI; Daniel GORDIN; Guido GRASSI; Charalampos GRASSOS; Dominique GUERROT; Justine HUART; Raffaele IZZO; Fernando Jaen AGUILA; Zoltan JARAI; Thomas KAHAN; Ilkka KANTOLA; Eva KOCIANOVA; FlorianP LIMBOURG; Marilucy LOPEZ-SUBLET; Francesca MALLAMACI; Athanasios MANOLIS; Maria MARKETOU; Gert MAYER; Alberto MAZZA; IainM MACINTYRE; Jean-Jacques MOURAD; Maria Lorenza MUIESAN; Edgar NASR; Peter NILSSON; Anna OLIVERAS; Olivier ORMEZZANO; Vitor PAIXAO-DIAS; Ioannis PAPADAKIS; Dimitris PAPADOPOULOS; Sabine PERL; Jorge POLONIA; Roberto PONTREMOLI; Giacomo PUCCI; Nicolas Roberto ROBLES; Sebastien RUBIN; Luis Miguel RUILOPE; Lars Christian RUMP; Sahrai SAEED; Elias SANIDAS; Riccardo SARZANI; Roland SCHMIEDER; Francois SILHOL; Sekib SOKOLOVIC; Marit SOLBU; Miroslav SOUCEK; George STERGIOU; Isabella SUDANO; Ramzi TABBALAT; Istemihan TENGIZ; Helen TRIANTAFYLLIDI; Konstontinos TSIOUFIS; Jan VACLAVIK; van der Giet MARKUS; Van der Niepen PATRICIA; Franco VEGLIO; RetoM VENZIN; Margus VIIGIMAA; Thomas WEBER; Jiri WIDIMSKY; Gregoire WUERZNER; Parounak ZELVEIAN; Pantelis ZEBEKAKIS; Stephan LUEDERS; Alexandre PERSU; Reinhold KREUTZ a Liffert VOGT. 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. Blood Pressure. Oxon: TAYLOR & FRANCIS, 2024, roč. 33, č. 1, s. 1-10. ISSN 0803-7051. Dostupné z: https://dx.doi.org/10.1080/08037051.2024.2368800. |
www | https://www.tandfonline.com/doi/full/10.1080/08037051.2024.2368800 |
Doi | http://dx.doi.org/10.1080/08037051.2024.2368800 |
Klíčová slova | Chronic kidney disease; hypertension; management; RAS blockers; hyperkalaemia; SGLT2 inhibitors; mineralocorticoid receptor antagonists; guidelines |
Popis | 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. |