Hypertension Fuels Chronic Kidney Disease

The greater the severity of hypertension, the greater the likelihood of kidney impairment, according to data from the National Kidney Foundation's Kidney Early Evaluation Program (KEEP). Even more concerning is evidence that more advanced stages of chronic kidney disease (CKD) are present once one surpasses the relatively mild blood pressure elevation of 130 mm Hg.

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Those are the findings of the latest KEEP Annual Data Report published as a special supplement to the April issue of the American Journal of Kidney Diseases, the official journal of the National Kidney Foundation.

KEEP is a voluntary, community-based screening program designed to raise awareness about kidney disease among high-risk individuals and provide free testing and educational information. Since its launch in 2000, approximately 125,000 individuals with diabetes, high blood pressure, or a family history of diabetes, hypertension, or kidney failure have been screened. Nearly one third showed evidence that they, themselves, already had kidney disease.

Senior author Dr. George L. Bakris at the University of Chicago School of Medicine and his associates report that "the probability of not reporting kidney impairment when present was significantly greater for participants with microalbuminuria or protein in the urine, providing an additional reason to assess microalbuminuria in hypertensive patients given this lack of awareness."

In their article, Dr. Bakris' team compared the KEEP data with that of the National Health and Nutrition Examination Survey (NHANES), a nationally representative sample of the US population. Results showed that hypertension with CKD, greater rates of CKD stages 3 and 4 in African Americans, obesity and diabetes were more prevalent in the KEEP data than in the NHANES data.

"Screening programs improve public heath, improve knowledge and communication, enhance adherence to recommended therapies, and improve clinical outcomes," the authors conclude.

KEEP is sponsored by Amgen, Abbott, Genzyme, Genentech, Novartis, Lifescan, Siemens and Suplena.