Hyperfiltration in hypertensive patients: results of epidemiological studies

Abstract

Aim. To evaluate prevalence of hyperfiltration (HF) in hypertensive patients, to estimate HF correlation with main demographic, clinical and laboratory data. Material and methods. A retrospective analysis was made by a proposed algorithm of 1160 case histories of outpatients and 1070 case histories of inpatients with hypertension. Glomerular filtration rate (GFR) was calculated by Mayo formula. 100 hypertensive patients with HF participated in telephone questionnaire survey. Also, 100 healthy medical students were examined. Results. HF was found in 15.83% examinees with hypertension and in no healthy subjects. HF patients had a shorter history of hypertension (4.64 ± 0.97 years), less frequent affection of target organs, type 2 diabetes mellitus, circulatory insufficiency. Most of the patients were males (82.35%, p < 0.05), they were significantly younger (mean age 51.93 ± 9.85 years) than the controls. Out of HF patients, 44.48, 26.35, 27.76% had arterial hypertension of the first degree, high normal pressure and hypertension of the second degree, respectively; 37.96% hypertensive patients with hyperfiltration received no treatment. In the absence of treatment for 2 years this group of patients exhibited a 12.12% fall in GFR, a 17.85 mm Hg rise of systolic and 7.4 mm Hg of diastolic pressure, a 10-fold increase of microalbuminuria. Overweight (body mass index in HF patients 31.51 ± 16.2 kg/m2) and smoking (68%) were among factors promoting GFR acceleration. Conclusion. Hyperfiltration develops at early stages of arterial hypertension in young patients and deteriorates prognosis. Therefore, preventive and therapeutic measures should be taken early with a focus on modification of the risk factors, first of all, obesity and smoking.

Keywords

• glomerular filtration rate
• hyperfiltration
• arterial hypertension
• epidemiology