Predictors Factors of Uncontrolled Masked Hypertension (MUCH) in Patients with Chronic Kidney Disease (CKD)

Area of Science:

• Nephrology
• Cardiology
• Hypertension Research

Background:

• Masked uncontrolled hypertension (MUCH) is a prevalent phenotype in patients with chronic kidney disease (CKD).
• MUCH is associated with increased risks of cardiovascular morbidity and mortality.
• Identifying predictors of MUCH in CKD patients is critical for early intervention and risk management.

Purpose of the Study:

• To identify factors predicting the masked uncontrolled hypertension (MUCH) phenotype in patients with chronic kidney disease (CKD).
• To develop a predictive model for MUCH in hypertensive CKD patients with in-office normotension.

Main Methods:

• A 7-year observational study (2017-2023) included hypertensive patients with CKD and in-office normotension.
• Ambulatory blood pressure monitoring (ABPM) classified patients into controlled hypertension (CH) or MUCH.
• Epidemiological, clinical, anthropometric, and laboratory data were analyzed to build a predictor model.

Main Results:

• Nearly half (49.5%) of the 220 participants had MUCH.
• Predictors of MUCH included higher diastolic blood pressure (DBP ≥75 mmHg), lower body mass index (BMI ≤25 Kg/m²), and elevated albuminuria (≥300 mg/g).
• Significant associations were found: DBP OR 1.93, BMI OR 2.21, and albuminuria OR 3.26.

Conclusions:

• Masked uncontrolled hypertension (MUCH) is a frequent condition in patients with arterial hypertension and CKD.
• Diastolic blood pressure ≥75 mmHg, BMI ≤25 Kg/m², and albuminuria ≥300 mg/g are significant predictors of MUCH in this population.
• These findings aid in identifying CKD patients at higher risk for MUCH and associated cardiovascular complications.