Pharmacotherapy of arterial hypertension in patients with chronic kidney disease in real clinical practice

Aim

To evaluate the antihypertensive therapy in patients with stage 3-5 chronic kidney disease (CKD) and arterial hypertension (AH) in the nephrological department of a multidisciplinary hospital.

Material and methods

In a retrospective study, we evaluated medical records of 258 hypertensive patients with stage 3-5 CKD who were admitted to the nephrology department of the Regional Clinical Hospital in Barnaul.

Results

The average number of prescribed antihypertensive drugs was 3.1 ± 0.1. The frequency of prescription was 72.5% for beta-blockers, 57.8% for calcium antagonists, 55.8% for thiazide and thiazide-like diuretics, 27.9% for loop diuretics, 1.9% for potassium-sparing diuretics, 40.7% for angiotensin converting enzyme inhibitors, 31.0% for angiotensin receptor blockers, 20.5% for central imidazoline receptor agonists, and 12.8% for alpha-blockers. The total frequency of renin-angiotensin system (RAS) blockers pre- scription was 69.4%. It decreased in patients with a lower glomerular filtration rate and a higher proteinuria. More than half of patients not receiving RAS blockers did not have clear contraindications for their use.

Conclusion

In real clinical practice, not all patients with CKD who require nephroprotection, particularly with stage 4-5 CKD and high proteinuria, receive this kind of treatment.

Key words

Chronic kidney disease, renin-angiotensin system blockers, arterial hypertension.