Biochemical and Paraclinical Evaluation of Organ Damage in Arterial Hypertension with Associated Chronic Kidney Disease

Teim Baaj,Shamsa Baaj,Elena Ardeleanu,Andrei Paunescu,Alin Cumpanas,Ioan Tilea,Ahmed Abu-Awwad,Mircea Botoca,Laurentiu Sima,Octavian Marius Cretu,Sebastian Plesa,Andrei Rusmir,Adina Elena Protesi,Silviu Latcu,Ioan Musta

doi:10.37358/rc.20.6.8183

Abstract

Organ damages, which contribute to the overall cardiovascular risk of hypertensive patients, should be early detected, prevented and treated. The study evaluated organ damage in a hypertensive study group with chronic kidney disease (CKD), compared with a study group of hypertension without CKD. Albuminuria was present in 41.2% and reduced estimated glomerular filtration rate [60 ml/min/m2 was present in 72.5% of hypertensive with CKD. The comparison of organ damage revealed in the CKD group a statistical significant higher prevalence of organ damage as follows: intima-media thickness ]0.9 mm in 39.9% vs 10.5%, carotid plaques in 28.2% vs 12.6%, left ventricular hypertrophy in 39.9% vs 31%, ankle brachial index in 6.2% vs 3.5%. Early detection and treatment of additional cardiovascular risk factors as dyslipidaemia and hyperglycaemia, that have significant role in the pathogenesis of organ damage, contribute to the better prevention of cardiovascular and renal complications in hypertension with CKD.

Highlights

Hypertension induces multiple structural and functional changes in the vasculature of the heart, brain, kidney and the retina
Their clinical, biochemical and paraclinical data were compared with a hypertension group without chronic kidney disease (CKD), consisting of 142 patients, in order to establish the role of risk factors for the development of Hypertension mediated organ damages (HMOD)
Detection of hypertension mediated organ damage in asymptomatic stages, when prevention and treatment strategies addressed to their reversal are efficient and cost-effective, imposes early diagnosis especially in primary care, where most of these hypertensive patients are followed up

Summary

Introduction

Hypertension induces multiple structural and functional changes in the vasculature of the heart, brain, kidney and the retina. Hypertension mediated organ damages (HMOD) progress to more severe cardiovascular diseases, which contribute to the grown cardiovascular morbidity and mortality characteristic for chronic kidney disease evolution [1]. As patients with mild and moderate degree of hypertension are usually treated in primary care, it results as necessary to include at this level a better routine detection and evaluation of risk factors and of target organ damages. LVH is detected in 25-35% of the hypertensive population, but its prevalence is much higher in the presence of associated CKD, ranging to 50-70% and contributing to the nearly triple cardiovascular morbidity and mortality of these patients [6,7]

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