Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Research Letter
  • Published:

Risk of chronic kidney disease in hypertensive patients with other metabolic conditions

Journal of Human Hypertension volume 22, pages 132–134 (2008)Cite this article

Using a retrospective cohort design and electronic medical records, we examined chronic kidney disease (CKD) risk over a 6-year period among hypertensive patients in relation to the presence of diabetes, hyperlipidaemia and/or high body mass index. After adjusting for age, sex, smoking status and baseline glomerular filtration rate (GFR), hypertensive patients without other metabolic risk factors had a relative risk of CKD (versus normotensive patients) of 2.0 (95% CI 1.8–2.2); hypertensive patients with other metabolic conditions had adjusted relative risks ranging from 2.4 to 2.6 for those without comorbid diabetes, and from 3.3 to 5.5 for those with comorbid diabetes. Our study thus confirms prior research demonstrating elevated CKD risk in hypertensive patients, and suggests that this risk varies substantially in relation to other metabolic conditions, especially diabetes.

Hypertension is a well-established risk factor for CKD.1, 2, 3 Many patients with hypertension also have other metabolic conditions, such as diabetes, hyperlipidaemia and obesity, and accumulating evidence suggests that the presence of multiple metabolic conditions increases CKD risk.2, 3, 4, 5, 6 However, prior research has not clarified the extent to which CKD risk may vary among hypertensive patients based on the specific combination of metabolic conditions that are present. We undertook a retrospective cohort study to examine this issue.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. National Kidney Foundation DOQI Guidelines. K/DOQI Clinical practice guidelines for chronic kidney disease: Evaluation, classification, and stratification, Available at http://www.kidney.org/professionals/kdoqi/guidelines.cfm. Accessed November 5, 2005.

  2. Kurella M, Lo JC, Chertow GM . Metabolic syndrome and the risk for chronic kidney disease among nondiabetic adults. J Am Soc Nephrol 2005; 16: 2134–2140.

    Article  Google Scholar 

  3. Fox CS, Larson MG, Leip EP, Culleton B, Wilson PWF, Levy D . Predictors of new-onset kidney disease in a community-based population. JAMA 2004; 291: 844–850.

    Article  CAS  Google Scholar 

  4. Sowers JR . Treatment of hypertension in patients with diabetes. Arch Intern Med 2004; 164: 1850–1857.

    Article  CAS  Google Scholar 

  5. Kannel WB . Risk stratification in hypertension: new insights from the Framingham Study. Am J Hypertens 2000; 13: 3S–10S.

    Article  CAS  Google Scholar 

  6. Verhave JC, Hillege HL, Burgerhof JGM, Gansevoort RT, De Zeeuw D, De Jong PE . The association between atherosclerotic risk factors and renal function in the general population. Kidney Int 2005; 67: 1967–1973.

    Article  Google Scholar 

  7. Brown JB, Pedula KL, Bakst AW . The progressive cost of complications in type 2 diabetes mellitus. Arch Intern Med 1999; 159: 1873–1880.

    Article  CAS  Google Scholar 

  8. Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D . A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Ann Intern Med 1999; 130: 461–470.

    Article  CAS  Google Scholar 

  9. Weycker D, Nichols GA, O'Keeffe-Rosetti M, Edelsberg J, Khan ZM, Kaura S et al. Risk-factor clustering and cardiovascular disease risk in hypertensive patients. Am J Hypertens 2007; 20: 599–607.

    Article  Google Scholar 

  10. American Diabetes Association. Standards of Medical Care-2007. Diabetes Care 2007; 30: S4–S41.

    Article  Google Scholar 

  11. Stevens LA, Coresh J, Greene T, Levey AS . Assessing kidney function—measured and estimated glomerular filtration rate. N Engl J Med 2006; 354: 2473–2483.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

Funding for this research was provided by Novartis Pharma AG.

Author information

Authors and Affiliations

  1. Policy Analysis Inc. (PAI), Brookline, MA, USA

    D Weycker, J Edelsberg & G Oster

  2. Kaiser Permanente, Center for Health Research, Portland, OR, USA

    G A Nichols & M O'Keeffe-Rosetti

  3. Novartis Pharma AG, Basel, Switzerland

    G Vincze

  4. Novartis Pharmaceuticals Corporation, East Hanover, NJ, USA

    Z M Khan

Authors
  1. D Weycker
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. G A Nichols
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M O'Keeffe-Rosetti
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. J Edelsberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. G Vincze
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Z M Khan
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. G Oster
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to D Weycker.

Additional information

Supplementary Information accompanies the paper on the Journal of Human Hypertension website (http://www.nature.com/jhh)

Supplementary information

Rights and permissions

Reprints and permissions

About this article

Cite this article

Weycker, D., Nichols, G., O'Keeffe-Rosetti, M. et al. Risk of chronic kidney disease in hypertensive patients with other metabolic conditions. J Hum Hypertens 22, 132–134 (2008). https://doi.org/10.1038/sj.jhh.1002276

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.jhh.1002276

This article is cited by

Search

Advanced search

Quick links