1. Management of patients with hypertension and chronic kidney disease referred to Hypertension Excellence Centres among 27 countries. On behalf of the European Society of Hypertension Working Group on Hypertension and the Kidney
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Jean-Michel Halimi, Pantelis Sarafidis, Michel Azizi, Grzegorz Bilo, Thilo Burkard, Michael Bursztyn, Miguel Camafort, Neil Chapman, Santina Cottone, Tine de Backer, Jaap Deinum, Philippe Delmotte, Maria Dorobantu, Michalis Doumas, Rainer Dusing, Béatrice Duly-Bouhanick, Jean-Pierre Fauvel, Pierre Fesler, Zbigniew Gaciong, Eugenia Gkaliagkousi, Daniel Gordin, Guido Grassi, Charalampos Grassos, Dominique Guerrot, Justine Huart, Raffaele Izzo, Fernando Jaén Águila, Zoltán Járai, Thomas Kahan, Ilkka Kantola, Eva Kociánová, FlorianP. Limbourg, Marilucy Lopez-Sublet, Francesca Mallamaci, Athanasios Manolis, Maria Marketou, Gert Mayer, Alberto Mazza, IainM. MacIntyre, Jean-Jacques Mourad, Maria Lorenza Muiesan, Edgar Nasr, Peter Nilsson, Anna Oliveras, Olivier Ormezzano, Vitor Paixão-Dias, Ioannis Papadakis, Dimitris Papadopoulos, Sabine Perl, Jorge Polónia, Roberto Pontremoli, Giacomo Pucci, Nicolás Roberto Robles, Sébastien Rubin, Luis Miguel Ruilope, Lars Christian Rump, Sahrai Saeed, Elias Sanidas, Riccardo Sarzani, Roland Schmieder, François Silhol, Sekib Sokolovic, Marit Solbu, Miroslav Soucek, George Stergiou, Isabella Sudano, Ramzi Tabbalat, Istemihan Tengiz, Helen Triantafyllidi, Konstontinos Tsioufis, Jan Václavík, Markus van der Giet, Patricia Van der Niepen, Franco Veglio, RetoM. Venzin, Margus Viigimaa, Thomas Weber, Jiri Widimsky, Gregoire Wuerzner, Parounak Zelveian, Pantelis Zebekakis, Stephan Lueders, Alexandre Persu, Reinhold Kreutz, and Liffert Vogt
- Subjects
Chronic kidney disease ,hypertension ,management ,RAS blockers ,hyperkalaemia ,SGLT2 inhibitors ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Objective Real-life management of patients with hypertension and chronic kidney disease (CKD) among European Society of Hypertension Excellence Centres (ESH-ECs) is unclear : we aimed to investigate it. Methods A survey was conducted in 2023. The questionnaire contained 64 questions asking ESH-ECs representatives to estimate how patients with CKD are managed. Results Overall, 88 ESH-ECS representatives from 27 countries participated. According to the responders, renin-angiotensin system (RAS) blockers, calcium-channel blockers and thiazides were often added when these medications were lacking in CKD patients, but physicians were more prone to initiate RAS blockers (90% [interquartile range: 70–95%]) than MRA (20% [10–30%]), SGLT2i (30% [20–50%]) or (GLP1-RA (10% [5–15%]). Despite treatment optimisation, 30% of responders indicated that hypertension remained uncontrolled (30% (15–40%) vs 18% [10%–25%]) in CKD and CKD patients, respectively). Hyperkalemia was the most frequent barrier to initiate RAS blockers, and dosage reduction was considered in 45% of responders when kalaemia was 5.5–5.9 mmol/L. Conclusions RAS blockers are initiated in most ESH-ECS in CKD patients, but MRA and SGLT2i initiations are less frequent. Hyperkalemia was the main barrier for initiation or adequate dosing of RAS blockade, and RAS blockers’ dosage reduction was the usual management.
- Published
- 2024
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