Antihypertensive prescribing patterns in non-dialysis dependent chronic kidney disease:Findings from the Salford Kidney Study  

作　　者：Rajkumar Chinnadurai Henry H L Wu Jones Abuomar Sharmilee Rengarajan David I New Darren Green Philip A Kalra 

机构地区：[1]Donal O’Donoghue Renal Research Centre&Department of Renal Medicine,Northern Care Alliance NHS Foundation Trust,Salford M68HD,United Kingdom [2]Department of Renal Research,Kolling Institute of Medical Research,Royal North Shore Hospital&The University of Sydney,St.Leonards(Sydney)2065,New South Wales,Australia [3]Faculty of Biology,Medicine&Health,The University of Manchester,Manchester M17HR,United Kingdom

出　　处：《World Journal of Nephrology》2023年第5期168-181,共14页世界肾病学杂志（英文版）

基　　金：the National Institute of Health Research Manchester Biomedical Research Centre for their funding support in the SKS(NIHR203308).

摘　　要：BACKGROUND Hypertension is commonly observed in patients living with chronic kidney disease(CKD).Finding an optimal treatment regime remains challenging due to the complex bidirectional cause-and-effect relationship between hypertension and CKD.There remains variability in antihypertensive treatment practices.AIM To analyze data from the Salford Kidney Study database in relation to antihypertensive prescribing patterns amongst CKD patients.METHODS The Salford Kidney Study is an ongoing prospective study that has been recruiting CKD patients since 2002.All patients are followed up annually,and their medical records including the list of medications are updated until they reach study endpoints[starting on renal replacement therapy or reaching estimated glomerular filtration rate(eGFR)expressed as mL/min/1.73 m2≤10 mL/min/1.73 m2,or the last follow-up date,or data lock on December 31,2021,or death].Data on antihypertensive prescription practices in correspondence to baseline eGFR,urine albumin-creatinine ratio,primary CKD aetiology,and cardiovascular disease were evaluated.Associations between patients who were prescribed three or more antihypertensive agents and their clinical outcomes were studied by Cox regression analysis.Kaplan-Meier analysis demonstrated differences in survival probabilities.RESULTS Three thousand two hundred and thirty non-dialysis-dependent CKD patients with data collected between October 2002 and December 2019 were included.The median age was 65 years.A greater proportion of patients were taking three or more antihypertensive agents with advancing CKD stages(53%of eGFR≤15 mL/min/1.73 m2 vs 26%of eGFR≥60 mL/min/1.73 m2,P<0.001).An increased number of patients receiving more classes of antihypertensive agents was observed as the urine albumin-creatinine ratio category increased(category A3:62%vs category A1:40%,P<0.001),with the upward trends particularly noticeable in the number of individuals prescribed renin angiotensin system blockers.The prescription of three or more antihypertensi

关 键 词：HYPERTENSION Chronic kidney disease Antihypertensive agents Prescribing patterns Cardiovascular complications Renin angiotensin system blockers 

分 类 号：R69[医药卫生—泌尿科学]