Uncontrolled hypertension in chronic kidney disease in patients from black Africa admitted in a renal unit: A retrospective analysis

The incidence of uncontrolled hypertension (HTN+) in CKD in nephrology could reflect the quality of the management of the patients in a primary care setting. The aim of the present study was to identify factors associated with HTN+ in CKD in order to elaborate a prevention strategy for the health professionals. A retrospective analysis of 479 incidents patients has been performed from 2012/1st to 2012/12th. Sixty-two percent had CKD HTN+. Eighty percent were at stages 4 and 5. Mean value of SBP was 166.5 +/- 32 mmHg and 96 +/- 27.3 mmHg for DBP. Mean age was 48.2 +/- 14.6 years. Mean GFR was 17.4 +/- 17.1 mL/min and no difference found between groups (17.4 +/- 17.6 mL/min in CKD HTN+ versus 17.5 +/- 16.3 mL/min in CKD HTN-, P < 0.9). Alcohol consumption was more in CKD HTN+ as compared to CKD HTN-, but not different between groups (37.2% in CKD HTN+ versus 27.6% in CKD HTN-; P <0.09). Patients who were taking antihypertensive drugs were significantly more in the CKD HTN- than CKD HTN+ (22% in CKD HT+ versus 41.1% in CKD HTN-; P < 0.0001). Factors associated with HTN+ in CKD were antihypertensive therapy (OR = 0.39; Cl 0.20-0.75; P < 0.005); alcohol (OR = 2.19; CI 1.09-4.37; P <0.02). BP was similar in HN and non-HN patients (173.0 +/- 26.9 mmHg versus 174.7 +/- 33.7 mmHg; P = 0.75). But kidney function was a little better in HN (16.9 +/- 17.7 mL/min and 20.95 +/- 18.5 mL/min; P < 0.1). Factors associated positively with HN/HTN+ were: history of HTN and age. Factors associated negatively with HN/HTN+ were: history of diabetes and CKD stage. (C) 2014 Association Societe de nephrologie. Published by Elsevier Masson SAS. All rights reserved.