The INCIDENCE AND RISK FACTORS FOR RAPID DECLINE OF PRESERVED ESTIMATED GLOMERULAR FILTRATION RATE AMONG PATIENTS WITH HYPERTENSION IN A COMMUNITY HOSPITAL

Abstract

Background: Hypertension is the second most common leading cause of chronic kidney disease. Related studies explored the causes of the rapid decline of kidney function in advanced kidney disease. However, the causes of the rapid decline of kidney function in the early stage or preserved function of hypertensionrelated kidney disease are less evident. Objectives: The study aimed to identify the incidence and associated risk factors for the decline of the glomerular filtration rate (GFR) among patients with hypertension with preserved kidney function, estimated GFR (eGFR) above 60/mL/min/1.73m2, at a community hospital. Methods: A retrospective cohort study was conducted among patients with hypertension with 2 eGFR measures at least 1 year apart and were identified from all cases attending at the Outpatient Department, Sanam Chai Khet Hospital, Chachoengsao Province. The incidence of the estimated rate of eGFR decline greater than 5 mL/min/1.73m2 yearly (ERGFR5/yr) was determined. In addition, potential risk and protective factors were identified using Poisson Regression. Results: Of 1,328 patients with hypertension, 53.05% were females. The mean age was 59.68 ± 11.58 years. The mean GFR measure at the 1st visit was 88.71± 14.73 mL/min/1.73m2. The incidence of ERGFR5/yr was 11.1 (95% CI: 10.1-12.3)) per 100-person year. Risk factors were being 60 years or older with an incidence rate ratio (IRR) of 1.4 (95% CI: 1.11-1.77), having diabetes mellitus with an IRR of 1.67 (95% CI: 1.37-2.04) and uncontrolled hypertension with an IRR of 1.15 (95% CI: 1.10-1.20). Conclusion: The incidence of ERGFR5/yr among renal preserved patients with hypertension was relatively low compared with other studies. Aggressive intervention among patients with comorbidity could reduce the incidence of rapid decline in eGFR.