BLOOD PRESSURE MANAGEMENT IN HYPERTENSIVE PATIENTS WITH NON-DIALYSIS CHRONIC KIDNEY DISEASE IN QUEENSLAND, AUSTRALIA

J ZHANG1,2, Z WANG1,2, O ADEGBIJA1,2, R ABEYSEKERA1,3, HG HEALY1,3, KS TAN1,4 , SK VENUTHURUPALLI1,2,5 , A CAMERON1,2, WE HOY1,2

1NHMRC CKD.CRE and CKD.QLD, Brisbane, Queensland; 2Faculty of Medicine, UQCCR, University of Queensland, Brisbane, Queensland; 3Kidney Health Service (RBWH); Metro North Hospital and Health Service, Brisbane, Queensland; 4Renal Services (Logan), Metro South Hospital and Health Service, Brisbane, Queensland;5Renal Services (Toowoomba Hospital), Darling Downs Hospital and Health Service, Queensland

Aim: To describe rates of blood pressure control and associated factors, and medication use in hypertensive patients with non-dialysis chronic kidney disease (CKD) in selected Australian settings.

Background: Hypertension is the most significant risk factor for the development and progression of CKD. Lowering blood pressure is a major treatment goal.

Methods: In a collaborative study with the iNet-CKD consortium, we identified patients from three public renal practices in CKD.QLD, who had CKD stage 3A to 5, and had hypertension (a formal diagnosis and/or use of antihypertensive agents). We describe the proportions of controlled blood pressure (<140/90 mmHg), demographic and clinical characteristics and use of antihypertensive medications on recruitment to the registry.

Results: Of 1,750 participants, 61.7% had controlled blood pressure, and 95.7% were on antihypertensive medications with 23%, 29%, 27% and 17% on 1, 2, 3, and ≥4 classes of antihypertensive medications respectively. Treatment included renin-angiotensin system blockers in 71%. Patients on a single antihypertensive medication had the highest rates of hypertension control (67.7%). Hypertension was more often uncontrolled among people with mild and severe albuminuria/proteinuria with adjusted prevalence ratios of 1.27 (95%CI 1.06-1.52) and 1.61 (1.36-1.91) respectively, and in people who were older (≥65 years), 1.2(1.04-1.38). In contrast, people with cardiovascular disease (CVD) were less likely to have uncontrolled blood pressure: 0.77 (0.68-0.87). The associations with albuminuria/proteinuria and with age applied to most programs in iNet-CKD; and the CVD findings applied for the programs in Canada, the UK and Uruguay.

Conclusions: Despite the high usage of medication to treat hypertension in these CKD.QLD patients, the blood pressure goal was met on a single occasion in around 60%. Longitudinal data are needed for future study.

About ANZSN

The ASM is hosted by Australian and New Zealand Society of Nephrology.

The aims of the Society are to promote and support the study of the kidney and urinary tract in health and disease, and to ensure the highest professional standards for the practice of nephrology in Australia and New Zealand.

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