Prehypertension as a risk factor for chronic kidney disease

A.G. Burmagina, A.Yu. Nikolaev

Purpose. To reveal the significance of prehypertension as a risk factor for CKD.
Material and Methods. The study included 94 men with prehypertension and 57 men with 1 degree arterial hypertension. The examination included detection of risk factors for CKD. Patients were allocated into 3 groups: 1st- with normal blood pressure (NBP), 2nd - with nigh normal blood pressure (HNBP), and 3rd - with 1 degree arterial hypertension, (1 degree AH). Patients of the 2nd and 3rd groups have received advice on non-drug correction of risk factors; in addition, patients of 3rd group have received valsartan (40–80 mg per day). A year later, examination of patients of the 2nd and 3rd groups was carried out.
Results. We have identified modifiable hemodynamic and metabolic factors associated with CKD against the background of HNBP comparable to those of 1 degree AH. In patients with HNBP the use of non-drug methods of correction of CKD risk factors was ineffective: increase in BMI, insulin resistance (IR), CRP, hyperuricosuria were detected. The number of patients with increased and high urinary albumin excretion (UAE) increased from 47 to 59%, decrease in GFR (<60 mL/min) was observed in 5% of patients. After year of observation, frequency of detection of early stages of CKD has reached 23%, transformation of VNAD in 1 degree AH was observed in 27% of cases; the detection rate of non-dippers increased from 33 to 38%, LVMMI by 2.1%. The use of valsartan has allowed to control of systolic and diastolic blood pressure (more than in 80% of patients), reduce the proportion of non-dippers by 27%, decrease in UAE by 25%, CRP by 16%, LVMMI by 2.8%, as well as decrease in uricosuria an IR. The prevalence of CKD has decreased by 37%.
Conclusion. According to our data, HNBP, as a form of prehypertension, is a subclinical stage of arterial hypertension, prone to progression, with high risk of CKD and cardiac complications.

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