L.A. Mishchenko. Predictors of renal function deterioration in patients with essential hypertension.

The aim – to establish predictors of kidney function deterioration in essential hypertensive (EH) patients, based on 5-years prospective observation.

Material and methods. 84 EH patients were included into the study. Circadian blood pressure rhythm, carbohydrate and lipid metabolism and activity of low-grade systemic inflammation were estimated at inclusion and after 5-years follow-up. Kidney function was evaluated by creatinine clearance and 24-hour urinary albumin excretion.

Results. Deterioration of kidney function was associated with worse quality of blood pressure (BP) control than in patients with normal kidney aging: 9.7 % versus 38.8 % of patients with BP <140/90 at follow-up visit. Lowering of the creatinine clearance correlated with increase of insulin resistance (r=–0.37; Р=0.02), increase of serum uric acid (r=–0.36; Р=0.01) and low-density lipoprotein cholesterol (r=–0.31; Р=0.02). According to the results of logistic regression analysis, predictors of kidney function decline are baseline blood creatinine, magnitude of 24-hour albumin excretion, activity of low grade inflammation and systolic pulse pressure. Conclusions. This prospective study shows that deterioration of renal function in EH patients depends not only on high pulse pressure level, but also on activation of the systemic inflammation and microalbuminuria.

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