Management of patients with hypertension and chronic kidney disease referred to Hypertension Excellence Centres among 27 countries. On behalf of the European Society of Hypertension Working Group on Hypertension and the Kidney

Halimi JM, Sarafidis P, Azizi M, Bilo G, Burkard T, Bursztyn M, Camafort M, Chapman N, Cottone S, de Backer T, Deinum J, Delmotte P, Dorobantu M, Doumas M, Dusing R, Duly-Bouhanick B, Fauvel JP, Fesler P, Gaciong Z, Gkaliagkousi E, Gordin D, Grassi G, Grassos C, Guerrot D, Huart J, Izzo R, Jaén Águila F, Járai Z, Kahan T, Kantola I, Kociánová E, Limbourg FP, Lopez-Sublet M, Mallamaci F, Manolis A, Marketou M, Mayer G, Mazza A, MacIntyre IM, Mourad JJ, Muiesan ML, Nasr E, Nilsson P, Oliveras A, Ormezzano O, Paixão-Dias V, Papadakis I, Papadopoulos D, Perl S, Polónia J, Pontremoli R, Pucci G, Robles NR, Rubin S, Ruilope LM, Rump LC, Saeed S, Sanidas E, Sarzani R, Schmieder R, Silhol F, Sokolovic S, Solbu M, Soucek M, Stergiou G, Sudano I, Tabbalat R, Tengiz I, Triantafyllidi H, Tsioufis K, Václavík J, van der Giet M, der Niepen PV, Veglio F, Venzin RM, Viigimaa M, Weber T, Widimsky J, Wuerzner G, Zelveian P, Zebekakis P, Lueders S, Persu A, Kreutz R, Vogt L (2024)

Publication Type: Journal article

Publication year: 2024

Journal

Book Volume: 33

Article Number: 2368800

Journal Issue: 1

DOI: 10.1080/08037051.2024.2368800

Abstract

Objective Real-life management of patients with hypertension and chronic kidney disease (CKD) among European Society of Hypertension Excellence Centres (ESH-ECs) is unclear : we aimed to investigate it. Methods A survey was conducted in 2023. The questionnaire contained 64 questions asking ESH-ECs representatives to estimate how patients with CKD are managed. Results Overall, 88 ESH-ECS representatives from 27 countries participated. According to the responders, renin-angiotensin system (RAS) blockers, calcium-channel blockers and thiazides were often added when these medications were lacking in CKD patients, but physicians were more prone to initiate RAS blockers (90% [interquartile range: 70–95%]) than MRA (20% [10–30%]), SGLT2i (30% [20–50%]) or (GLP1-RA (10% [5–15%]). Despite treatment optimisation, 30% of responders indicated that hypertension remained uncontrolled (30% (15–40%) vs 18% [10%–25%]) in CKD and CKD patients, respectively). Hyperkalemia was the most frequent barrier to initiate RAS blockers, and dosage reduction was considered in 45% of responders when kalaemia was 5.5–5.9 mmol/L. Conclusions RAS blockers are initiated in most ESH-ECS in CKD patients, but MRA and SGLT2i initiations are less frequent. Hyperkalemia was the main barrier for initiation or adequate dosing of RAS blockade, and RAS blockers’ dosage reduction was the usual management.

Authors with CRIS profile

Involved external institutions

University Hospital Ghent Belgium (BE) European Society of Hypertension (ESH) Italy (IT) General Hospital of Attica (KAT) / γενικο νοσοκομειο αττικης Greece (GR) Hospital Center University Rouen / Centre hospitalier universitaire de Rouen (CHU) France (FR) University of Liège (ULg) / Université de Liège Belgium (BE) Università degli Studi di Napoli Federico II Italy (IT) Complejo Hospitalario Universitario de Granada Spain (ES) St. Imre Teaching Hospital Hungary (HU) Karolinska Institute Sweden (SE) Turku University Hospital / Turun yliopistollinen keskussairaala (TYKS) Finland (FI) Palacky University Olomouc / Univerzita Palackého v Olomouci Czech Republic (CZ) Medizinische Hochschule Hannover (MHH) / Hannover Medical School Germany (DE) Avicenne Hospital / Hôpital Avicienne France (FR) Consiglio Nazionale delle Ricerche (CNR) / National Research Council of Italy Italy (IT) Metropolitan Hospital Greece (GR) University General Hospital of Heraklion Greece (GR) Medizinische Universität Innsbruck Austria (AT) Western General Hospital United Kingdom (GB) Hôpital Franco-Britannique France (FR) Università degli Studi di Brescia Italy (IT) Saint George Hospital University Medical Center Lebanon (LB) Hôpital Albert Michallon France (FR) Centro Hospitalar de Vila Nova de Gaia Portugal (PT) Laikο General Hospital of Athens Greece (GR) Medizinische Universität Graz Austria (AT) Centre for Health Technology and Services Research / Centro de Investigação em Tecnologias e Serviços de Saúde (CINTESIS) Portugal (PT) Ospedale Policlinico San Martino Italy (IT) Università degli Studi di Perugia Italy (IT) Centre Hospitalier Universitaire de Bordeaux / CHU Bordeaux France (FR) Heinrich-Heine-Universität Düsseldorf Germany (DE) Haukeland University Hospital / Haukeland universitetssykehus Norway (NO) Università Politecnica delle Marche (UNIVPM) / Marche Polytechnic University Italy (IT) Hôpital de la Timone France (FR) Plava Medical Group Bosnia And Herzegovina (BA) University Hospital of North Norway / Universitetssykehuset Nord-Norge (UNN) Norway (NO) St. Anne's University Hospital / Sv. Anny v Brně Czech Republic (CZ) Hôpital Bretonneau France (FR) Aristotle University of Thessaloniki Greece (GR) Université Sorbonne Paris Cité France (FR) Instituto Auxologico Italiano Italy (IT) Universitätsspital Basel Switzerland (CH) Hadassah Medical Center / מרכז רפואי הדסה‎‎ Israel (IL) Universitat de Barcelona (UB) / University of Barcelona Spain (ES) Hammersmith Hospital United Kingdom (GB) Policlinico Universitario Paolo Giaccone Italy (IT) Radboud University Nijmegen Medical Centre / Radboudumc of voluit Radboud Universitair Medisch Centrum (UMC) Netherlands (NL) Bucharest Emergency University Hospital Romania (RO) Université Fédérale de Toulouse Midi-Pyrénées France (FR) Hôpital Edouard Herriot France (FR) Centre Hospitalier Universitaire de Montpellier (CHU/CHRU MTP) France (FR) Wrocław Medical University / Uniwersytet Medyczny we Wrocławiu Poland (PL) Helsinki University Central Hospital (HUCH) / Helsingin seudun yliopistollinen keskussairaala (HYKS) Finland (FI) University of Milano-Bicocca / Università degli Studi di Milano-Bicocca, UNIMIB Italy (IT) Lund University / Lunds universitet Sweden (SE) Universitat Pompeu Fabra (UPF) Spain (ES) National and Kapodistrian University of Athens Greece (GR) Universitätsspital Zürich (USZ) Switzerland (CH) Abdali Hospital Jordan (JO) Medicana International Izmir Hospital Turkey (TR) University Hospital Ostrava / Fakultní Nemocnice Ostrava Czech Republic (CZ) Charité - Universitätsmedizin Berlin Germany (DE) Universitair Ziekenhuis Brussel Belgium (BE) University of Turin / Università degli Studi di Torino (UNITO) Italy (IT) Kantonsspital Graubünden Switzerland (CH) Tallinn University of Technology Estonia (EE) Klinikum Wels-Grieskirchen Austria (AT) General University Hospital in Prague / Všeobecná Fakultní Nemocnice v Praze (VFN) Czech Republic (CZ) Lausanne University Hospital / Centre hospitalier universitaire vaudois (CHUV) Switzerland (CH) St. Josefs-Hospital Cloppenburg gemeinnützige GmbH Germany (DE) Cliniques universitaires Saint-Luc (CHU St-Luc) Belgium (BE) Amsterdam University Medical Centers (Amsterdam UMC) / Amsterdam Universitair Medische Centra Netherlands (NL)

How to cite

APA:

Halimi, J.M., Sarafidis, P., Azizi, M., Bilo, G., Burkard, T., Bursztyn, M.,... Vogt, L. (2024). Management of patients with hypertension and chronic kidney disease referred to Hypertension Excellence Centres among 27 countries. On behalf of the European Society of Hypertension Working Group on Hypertension and the Kidney. Blood Pressure, 33(1). https://doi.org/10.1080/08037051.2024.2368800

MLA:

Halimi, Jean Michel, et al. "Management of patients with hypertension and chronic kidney disease referred to Hypertension Excellence Centres among 27 countries. On behalf of the European Society of Hypertension Working Group on Hypertension and the Kidney." Blood Pressure 33.1 (2024).

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