Main Organiser

Julius Centre University of Malaya

Co-organiser

Department of Social and Preventive Medicine, Faculty of Medicine, University of Malay

Supported by

University of Malaya

COMPARISON OF CHANGE IN ESTIMATED GLOMERULAR FILTRATION RATE OVER A TEN YEAR PERIOD IN HYPERTENSIVE AND NON-HYPERTENSIVE PATIENTS FROM A PRIMARY CARE CLINIC

Author

Chia YC, Tan SF

Institution

University of Malaya

Abstract

Objectives: Chronic kidney disease is a recognised complication of hypertension. This study examines the change in estimated glomerular filtration rate (eGFR) over a 10-year period between hypertensive and non-hypertensive patients attending an outpatient primary care clinic.

Methods: This is a retrospective cohort study. Patients 30 years and over, without known cerebrovascular disease in 1998, were randomly selected. Demographic data, blood pressure (BP), body weight, serum creatinine and anti- hypertensive drug usage at baseline and at 10 years were captured.

Results: 1613 patients entered the study (mean age 56.5years; 34.5% male). In 1998 and 2007, 930 (57.7%) and 1264 (78.4%) patients respectively were on pharmacological treatment for hypertension. The mean BP of hypertensives and non-hypertensives was 140/85 and 132/81.3mmHg respectively at baseline and 134.9/79 and 127.2/76.8mmHg at the end of 10 years. Both groups showed a reduction in BP over time. The eGFR of the hypertensive and non-hypertensive group was 78 and 82.9ml/mim respectively at baseline and 67.7 and 74.6ml/min at the end of 10 years. The reduction of 10.3 and 8.3 ml/min in the hypertension and non-hypertension patients respectively at the end of 10 years was not statistically significant (p=0.17).

Conclusion: The expected greater deterioration in renal function in hypertensive patients compared to non-hypertensive patients was not seen. This could be in part explained by the significant improvement in BP control and the greater number of anti-hypertensive drugs used, in particular ACE-inhibitors /AII RBs over a 10 year period. Nonetheless greater effort is needed to get all patients treated to target.