Evolution of the stage of chronic kidney disease from the diagnosis of hypertension in primary care

从初级保健中诊断高血压到慢性肾脏病阶段的演变

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Abstract

OBJECTIVE: To analyze the evolution of the stages of CKD and the progression of the estimation of glomerular filtration rate (eGFR) in patients with newly diagnosed hypertension. DESIGN: Retrospective cohort. SITE: Family Medicine Unit No. 31, Mexican Social Security Institute, Mexico City. PARTICIPANTS: Patients with hypertension who have been diagnosed in primary care and have developed chronic kidney disease. MAIN MEASUREMENTS: The eGFR was calculated with the CKD Epi formula in three moments, the first measurement was at the time of diagnosis of hypertension, the second measurement was made when it arrived a change in CKD stage and the last one at the end of the study, with which the evolution time from one stage to another was obtained, as well as the drop in eGFR. RESULTS: The sample consisted of 207 electronic health records of patients, with an average follow-up of 10.2 years from the moment of diagnosis of hypertension until the end of the study. The average time to go from one baseline stage of CKD to another was 7 years (average decline in eGFR of 5.8ml/min/year) and to have a second stage change was 3.2 years (average decline in eGFR of 6.8ml/min/year), with a statistically significant repeated measures ANOVA (p<0.001). CONCLUSIONS: Patients with newly diagnosed hypertension remain longer in the initial stages of CKD, to later evolve and change more quickly.

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