A model for predicting the risk of developing chronic kidney disease in patients with second-stage hypertension, depending on gender

   Hypertension is a chronic progressive disease, in the absence of correction of which, target organs are involved in the pathological process, with the disease worsening and the life expectancy deterioration. Chronic kidney disease (CKD) develops in about 30 % of patients with hypertension, causing the development of cardiovascular complications, including death. The prognostically unfavorable combinations of risk factors in men and women, which will inevitably lead to the development of CKD, have not been fully studied.

   Aim of the study was to build a model for predicting the risk of developing CKD in patients with stage II GB, depending on gender.

   Material and methods. 100 patients aged 60.5 [20.0] years (median [interquartile region]) with a diagnosis of stage II hypertension were examined. The main group included 50 patients with CKD (men – 21, women – 29, age 64.0 [19.1] years), the comparison group included 50 patients without CKD (men – 25, women – 25, age 58.5 [22.1]). The presence of metabolic syndrome was determined in all of them, systolic and diastolic blood pressure were measured, the salt sensitivity taste threshold, uric acid and blood creatinine content were estimated, the glomerular filtration rate was calculated, аn echocardiographic study was performed, and the severity of depression using the Beck scale was assessed.

   Results and discussion. It turned out that in men with stage II hypertension, the risk of developing CKD is more determined by such combinations of risk factors as the threshold of taste sensitivity to table salt, blood uric acid content, and depression severity according to the Beck scale, in women it was metabolic syndrome presence, depression severity, systolic arterial pressure at admission.

   Conclusions. Models for predicting the risk of developing CKD in patients with stage II GB differ by gender, are easy to use, will allow the practitioner to accurately determine the probability of kidney damage in men and women with hypertension, optimize therapy considering the identified predictors and slow down the progression of hypertension stage of GB and related complications.

1. Murkamilov I.T., Aitbaev K.A., Fomin V.V., Murkamilova Zh.A., Astanin P.A., Yusupova T.F., Yusupov F.A. Kidney damage in hypertensive disease. Klinicheskaya meditsina = Clinical Medicine. 2023;101(11):569–576. [In Russian]. doi: 10.30629/0023-2149-2023-101-11-569-576

2. Ebzeeva E.Yu., De V.A., Ni L.I., Sokolova E.V., Arablinskii A.V., Ostroumova O.D. Chronic kidney disease and hypertension: how to break the vicious circle? Russkiy meditsinskiy zhurnal = Russian Medical Journal. 2022;(5):30–34. [In Russian].

3. Sigitova O.N., Bogdanova A.R., Saubanova E.I. Risk factors, prevalence and rates of chronic kidney disease progression in outpatient patients with arterial hypertension. Terapiya = Therapy. 2023;(3):7–14. [In Russian]. doi: 10.18565/therapy.2023.3.7-14

4. Chazova I.E., Kislyak O.A., Podzolkov V.I., Bragina A.E., Sivakova O.A., Solntseva T.D., Elfimova E.M., Valieva Z.S., Fomin V.V., Mironova O.Yu. Arterial hypertension and chronic kidney disease: consensus statement on patient management. Sistemnye gipertenzii = Systemic Hypertension. 2023;20(1):5–19. [In Russian]. doi: 10.38109/2075-082X-2023-1-5-19

5. Kobalava Zh.D., Villeval’de S.V., Bagmanova N.Kh., Batyushin M.M., Orlova G.M. The prevalence of chronic kidney disease markers in arterial hypertension patients and relation with diabetes: results of epidemiological study KHRONOGRAPH. Rossiyskiy kardiologicheskiy zhurnal = Russian Journal of Cardiology. 2018;23(2):91–101. [In Russian]. doi: 10.15829/1560-4071-2018-2-91-101

6. Kobalava Zh.D., Konradi A.O., Nedogoda S.V., Shlyakhto E.V., Arutyunov G.P., Baranova E.I., Barbarash O.L., Boitsov S.A., Vavilova T.V., Villevalde S.V., … Yanishevsky S.N. Arterial hypertension in adults. Clinical guidelines 2020. Rossiyskiy kardiologicheskiy zhurnal = Russian Journal of Cardiology. 2020;25(3):149–218. doi: 10.15829/1560-4071-2020-3-3786

7. Clinical recommendations. Chronic kidney disease, 2023. Approved by the Ministry of Health of the Russian Federation. Moscow: Tsentromag, 2024. 226 p. [In Russian].

8. Henkin R.J., Gill L.P., Bartter F.C.J. Studies on taste threshold in normal man and in patients with adrenal cortical insufficiency: the role of adrenal cortical steroids and of serum sodium concentration. Clin. Invest. 1963;42(5):727‒735.

9. Volkov V.S., Poselyugina O.B., Svistunov O.P. On the role of table salt in the pathogenesis of hypertension. Kardiovaskulyarnaya terapiya i profilaktika = Cardiovascular Therapy and Prevention. 2005; 4(2):35-39. [In Russian].

10. Trukhacheva N.V. Medical statistics : a textbook. Rostov na Donu: Feniks, 2017. 324 р. [In Russian].