LOW AWARENESS OF GENERAL PRACTITIONERS ON KIDNEY FUNCTION AND CHRONIC KIDNEY DISEASE IN HYPERTENSIVE PATIENTS. PRELIMINARY REPORT FOR NORTH-WEST PART OF CROATIA

Abstract

Objective: The prevalence of hypertension (HT) in general Croatian population is 37%. We are still lacking data on prevalence of HT in Zagorje County, North West part of Croatia and characteristics of this population (prevalence of associated risk facotrs and co-morbidity). Our aim was to analyse characteristics of consecutive sample of patients who were referred from GPs and examined in nephrology unit in local hospital. Design and method: Data on subjects who were examined in nephrology outpatient unit in GH Zabok from November 2018 till January 2019 were analyzed. Blood pressure was measured using Omron M6 device and ABPM using Moil-O-Graph during regular working day. Fasting blood sample and urine were collected after clinical exam and BP measurements. Chronic kidney disease (CKD) was defined as eGFR (CKD Epi) <60 ml/min/1.73 m2. Results: In a consecutive sample of patients 54% of them have CKD (mostly CKD stage 3b 63%), suggesting a late referral of hypertensive patients to a nephrologist. In the whole group we found 28% of them to have diabetes type 2. However, in none of them, albuminuria was determined. Arterial hypertension was treated either with monotherapy or using fixed dose combination therapy which was utilized in only 51% of patients. Heart rate, an independent cardiovascular risk factor more than 80 was present in 47% of patients. Conclusions: Analyzing data of this sample of patients from real life we found that general practitioners, at least in this part of Croatia, are unaware that determination of kidney function is important part of regular exam and that CKD is important independent prognostic factor in hypertensive patients. GPs should more closely collaborate with hypertension specialist/ nephrologist and should be regular partners in multidisciplinary team.