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Importance of recognizing occult renal disease in hypertensive patients

Lorenzo Fácila1, Vicente Bertomeu-González, Vicente Bertomeu

  • 1Servicio de Cardiología, Hospital Provincial de Castellón, Avda. Dr. Clara, 19. 12002 Castellón de la Plana, Spain. lfacila@gmail.com

Revista Espanola De Cardiologia
|March 10, 2009
PubMed

Insights

Nearly 10% of hypertensive patients seen by cardiologists have undiagnosed occult renal disease (ORD). This unrecognized population faces intermediate cardiovascular risk, highlighting the need for glomerular filtration rate (GFR) screening.

Area of Science:

  • Cardiology
  • Nephrology
  • Public Health

Background:

  • Occult renal disease (ORD) represents early-stage renal failure undetectable by routine monitoring.
  • Hypertension is a major risk factor for cardiovascular and renal diseases.
  • Cardiology clinics manage patients with significant cardiovascular risk, often overlapping with renal comorbidities.

Purpose of the Study:

  • To determine the prevalence of ORD in hypertensive patients attending cardiology outpatient clinics.
  • To identify associations between ORD and cardiovascular risk factors or treatments.
  • To assess the impact of age on ORD prevalence in this cohort.

Main Methods:

  • A cross-sectional, retrospective, multicenter observational study.
  • Involved 1214 hypertensive patients from cardiology outpatient clinics.
  • Glomerular filtration rate (GFR) was calculated using the Modification of Diet in Renal Disease equation in a subset of patients.

Main Results:

  • Data from 1190 patients were analyzed; 9.5% had occult renal disease (ORD).
  • ORD was more common in females, older patients, and those with dyslipidemia, diabetes, sedentary lifestyle, atrial fibrillation, or long-standing hypertension.
  • Prevalence increased with age, from 2.9% in those under 50 to 13.5% in those over 70.

Conclusions:

  • Approximately 10% of hypertensive patients managed by cardiologists exhibit undiagnosed moderate renal dysfunction.
  • These patients constitute an unrecognized group with intermediate cardiovascular risk.
  • Calculating GFR, particularly in women and older individuals, is recommended for early detection and management.
Abstract

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