Interim analysis of prospective observational multicenter study of patients with hypertension and chronic kidney disease in the Russian Federation (PRIORITY-CKD)

Aim. To describe the detection rate of chronic kidney disease (CKD) in patients with hypertension (HTN) and markers of CKD without concomitant diabetes and symptomatic heart failure, as well as to describe the clinical and demographic characteristics and features of therapy in the overall cohort and a subgroup with verified CKD.

Material and methods. The article presents an interim analysis of data from a prospective observational multicenter study of patients with HTN and CKD in the Russian Federation (PRIORITY-CKD).

Results. Data from the first 3249 patients included in the study were analyzed. In 2592 (79,8%) patients with HTN and CKD markers, the diagnosis of CKD was confirmed during the study as follows: in 1380 (42,5%) at Visit 1 and in 1212 (37,3%) at Visit 2. In 2488 (96%) cases, only the estimated glomerular filtration rate was used as the criteria for the diagnosis of CKD. Only in 12 patients (0,5%) albuminuria or proteinuria (alone or together with other CKD markers) was used as diagnostic criteria for CKD diagnosis.  Cases of overdiagnosis (12,6%) and underdiagnosis (0,4%) of CKD were identified. In the overall cohort and the subgroup with verified CKD, women predominated (61,6/62,1%), while the median duration of HTN was 9 and 10 years, respectively. More than half of the patients had stage III HTN and very high cardiovascular risk. A high rate of metabolic risk factors (overweight, dyslipidemia, abdominal obesity) and atherosclerotic cardiovascular diseases was noted. Coronary artery disease was observed in a third of patients in the overall cohort and the CKD subgroup. Uncontrolled HTN (systolic BP ≥140 and/or diastolic BP ≥90 mm Hg despite antihypertensive therapy) and resistant HTN were detected in 42,5% and 6,7% of patients in the overall cohort, while in the subgroup with CKD in 42,1% and 7,3%, respectively. Combination antihypertensive therapy after Visit 1 was received by 78,8% of patients in the examined cohort. Only in 21,4% of cases, sodium-glucose cotransporter-2 inhibitors were prescribed after verification of the CKD diagnosis.

Conclusion. In the Russian population, the diagnosis of CKD was confirmed in 79,8% of patients with HTN and CKD markers. Albuminuria/proteinuria was assessed extremely rarely. Cases of overdiagnosis and underdiagnosis of CKD were identified. A high rate of uncontrolled HTN and a serious burden of atherosclerotic cardiovascular diseases were observed in the overall cohort and the subgroup with CKD. After CKD verification, a suboptimal increase in the prescription of sodiumglucose cotransporter-2 inhibitors was noted.

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