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Long term evolution of renal function in essential hypertensive patients with no baseline proteinuria

Journal of Human Hypertension volume 34, pages 560–567 (2020)Cite this article

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Abstract

Data on the long term evolution of renal function in essential hypertensive patients are scarce, showing a low incidence of end stage renal diseases but without information on how the renal function evolves. Our aim is to describe the long term evolution of renal function and possible trajectories in hypertensive patients. We included patients from an ongoing cohort with essential hypertension, no proteinuria at baseline and no diabetes during follow-up and with at least two creatinine dosages 4 years apart. A long term (average 16 years) follow-up was available in 609 patients (baseline age 51.8 ± 11.1 years, 52 % male, mean office BP 156//95 mmHg). The trajectories of creatinine were modeled through a flexible latent class mixed model. The analysis identified three classes of significantly different trajectories. In the first (n = 560), there was no significant variation of creatinine over time. In the second (n = 40), there was a significant rise of creatinine (117 ± 20 vs 85 ± 17 µmol/l, p < 0.0001). The third class (n = 9) was very heterogeneous, mainly composed of outliers. Further analysis showed the nonlinearity of the evolution of creatinine in classes 2 and 3. So the model of progressive renal deterioration in essential hypertension does not fit with our results. A large majority (92%) of patients show no significant change in creatinine level with time. In the others 8%, the increase in creatinine is not progressive but conversely show one or more sudden bouts of elevation.

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Acknowledgements

We thank Jeremy Reyburn for his rapid and efficient help in translating our paper.

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Authors and Affiliations

  1. Hypertension excellence center, University hospital of Bordeaux, Hôpital Saint André, 1 avenue Jean Burguet, 33075, Bordeaux, France

    Philippe Gosse, Romain Boulestreau & Antoine Cremer

  2. Centre INSERM U1219-Bordeaux Population Health, Team Biostatistics, Univ. Bordeaux, ISPED, Bordeaux, France

    Corentin Segalas, Helene Jacqmin-Gadda & Karen Leffondre

  3. Service de Néphrologie Transplantation Dialyse, Centre Hospitalier Universitaire de Bordeaux, Hôpital Pellegrin, Bordeaux, France

    Sébastien Rubin & Christian Combe

  4. INSERM CIC-1401-Clinical Epidemiology, F-33000, Bordeaux, France

    Karen Leffondre

  5. Unité INSERM 1026, Univ. Bordeaux, Bordeaux, France

    Christian Combe

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  1. Philippe Gosse
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Correspondence to Philippe Gosse.

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Gosse, P., Segalas, C., Rubin, S. et al. Long term evolution of renal function in essential hypertensive patients with no baseline proteinuria. J Hum Hypertens 34, 560–567 (2020). https://doi.org/10.1038/s41371-019-0245-4

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