Renal Insufficiency in Treated Essential Hypertension

Publisher Website
Google Scholar
Abstract
We analyzed the clinical courses of 94 patients with treated primary hypertension and initially normal serum creatinine concentrations (≤133 μmol per liter [≤1.5 mg per deciliter]) who were followed for a mean (±SD) of 58±34 months (range, 12 to 174) to determine the frequency with which renal function deteriorated and the factors associated with deterioration. Fourteen patients (15 percent) had an increase in serum creatinine concentrations (≥35 μmol per liter [≥0.4 mg per deciliter]); in 16 percent of the 61 patients with apparently good control of blood pressure, the serum creatinine concentration rose 59±33 μmol per liter (0.67±0.38 mg per deciliter). Despite good control of diastolic blood pressure (≤90 mm Hg), black patients were twice as likely as white patients to have elevations in serum creatinine (23 percent vs. 11 percent). Stepwise discriminant function analysis showed that a significant rise in the serum creatinine concentration was most likely to occur in association with older age, black race, a higher number of missed office visits, and employment as a laborer.