Abstract

Objective: Chronic kidney disease (CKD) is recognized as an independent cardiovascular disease (CVD) risk state. Arterial hypertension (AH) and type 2 diabetes mellitus (T2DM) are leading risk factors for both CVD and CKD. The aim of the study was to assess the prevalence of decreased glomerular filtration rate (GFR) and high/ very high albuminuria in patients with AH and T2DM. Design and method: In 319 patients with AH and T2DM admitted in city clinical hospital (37% men, age 65 ± 11 years (M ± SD), body mass index 30 ± 7 kg/m2, blood pressure 135 ± 16/80 ± 9 mmHg, median AH duration 12 years (interquartile range 10;15), T2DM duration 10 years (4;15), dyslipidemia 70%, chronic heart failure 50%, anemia 28%, atrial fibrillation 20%) GFR was assessed by CKD-EPI equation and albuminuria – by albumin/creatinine ratio (ACR) in spot urine morning sample. Results: GFR<60 ml/min/1.73 m2 was revealed in 127 (39.8%) patients, wherein GFR in the range of 45-<60, 30-<45, 15-<30, <15 ml/min/1.73 m2 was found in 18, 17, 5 and 0.6% respectively. ACR>30 mg/g was detected in 123 (39%) of patients, wherein ACR in the range 30-<300 and >300 mg/g was found in 29 and 10%. CKD criteria (GFR<60 ml/min/1.73 m2 and/or ACR>30 mg/g) were detected in 182 (57%) patients. Non-albuminuric CKD (GFR<60 ml/min/1.73 m2 without albuminuria) was found in 59 (18.5%) patients, isolated (without GFR decrease<60 ml/min/1.73 m2) high/ very high albuminuria - in 55 (17%) patients, combined decreased GFR and high/very high albuminuria – in 68 (22%) patients. Patients with vs without albuminuria were older (67.2 ± 10.8 vs 63.7 ± 10.7 years), more aware of kidney diseases (59 vs 41%), had lower level of hemoglobin (122 ± 23 vs 130 ± 21 g/l), p < 0.05 for all. Patients with vs without CKD criteria were older (67 ± 10 vs 60 ± 11 years), had higher prevalence of anemia (34 vs 10%), heart failure (55 vs 32%). Conclusions: High prevalence (57%) of CKD criteria was revealed in hospitalized patients with AH and T2DM. GFR<60 ml/min/1.73 m2 was found in 39.8% of patients, ACR>30 mg/g – in 39%, combined decreased GFR and high/ very high albuminuria – in 22% of patients.

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