Annual deterioration of renal function in hypertensive patients with and without diabetes

• Published in: Vascular health and risk management 2017-01, Vol.13, p.231-237
• Main Authors: Polonia, Jorge, Azevedo, André, Monte, Miguel, Silva, José A, Bertoquini, Susana
• Format: Article
• Language: English
• Subjects: Age Factors; Aged; Albuminuria - etiology; Albuminuria - physiopathology; annual deterioration; Antihypertensive Agents - therapeutic use; Biomarkers - blood; Blood Glucose - metabolism; Blood Pressure; Blood Pressure Monitoring, Ambulatory; Body mass index; Care and treatment; Chi-Square Distribution; Circadian Rhythm; Collaboration; Complications and side effects; Development and progression; Diabetes; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - diagnosis; Diabetes Mellitus, Type 2 - drug therapy; Diabetic Nephropathies - diagnosis; Diabetic Nephropathies - etiology; Diabetic Nephropathies - physiopathology; Disease Progression; Female; Glomerular Filtration Rate; Glycated Hemoglobin A - metabolism; Hospitals; Humans; Hypertension; Hypertension - complications; Hypertension - diagnosis; Hypertension - drug therapy; Hypertension - physiopathology; Hypoglycemic Agents - therapeutic use; Kidney - physiopathology; Kidney diseases; Linear Models; Male; Middle Aged; Multivariate Analysis; Original Research; Patients; Physiological aspects; Renal function; Renal Insufficiency, Chronic - diagnosis; Renal Insufficiency, Chronic - etiology; Renal Insufficiency, Chronic - physiopathology; Retrospective Studies; Risk Factors; Severity of Illness Index; Sleep; Statistical analysis; Time Factors; Type 2 diabetes; Urine; Variables
• ISSN: 1178-2048; 1176-6344; 1178-2048
• DOI: 10.2147/VHRM.S135253

Chronic kidney disease (CKD) complicates hypertension and diabetes. Knowledge of the deterioration rate of CKD may anticipate adjustment of therapies with renal elimination. This study evaluates the rate of annual deterioration of renal function in hypertensive patients either with type 2 diabetes (DM2) or without it (non-DM) followed for 5 years and relates it with blood pressure (BP) and glycemic control. Out of a total of 1924 patients, 1023 patients (594 non-DM and 429 DM2, 53% female, aged 62.1±10.2 years) were evaluated over 5 years for the annual evolution of renal function (estimated glomerular filtration rate [eGFR], Modification of Diet in Renal Disease) ambulatory 24-hour blood pressure and metabolic parameters, corresponding to the analysis of 2378 patient-years. DM2 and non-DM did not differ for age, mean 24-hour BP levels, nighttime BP, albuminuria, and body mass index. DM2 versus non-DM showed a higher (