PP.25.23: HYPERTENSION CORRELATES WITH HYDRATION STATUS IN A POPULATION OF CHRONIC KIDNEY DISEASE PATIENTS. (June 2015)

• Record Type: Journal Article
• Authors: Campos, P.; Alvellos-Leitão, M.J.; Pires, A.; Inchaustegui, L.
• Is Part Of: Journal of hypertension. Volume 33(2015)Supplement 1
• Publication Date: 2015-06
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000468483.13872.e8
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: Hypertension (HTN) is a major risk factor for chronic kidney disease (CKD) progression and is strongly associated with obesity, metabolic syndrome and high cardiovascular disease (CVD) risk. We aimed to study hypertension (HTN) prevalence in a group of CKD patients (pts) and its association with demographic, clinical and biochemical characteristics, as well as nutritional and body water levels. Design and method: Cross sectional, prospective study. Patient population included CKD pts stage I to V not on dialysis followed as outpatients at a Nephrology Hospital Department. Estimated glomerular filtration rate (eGFR) was calculated using Cockcroft-Gault equation. InBody Segmental Multi-frequency Bioelectrical Impedance Analysis (BIA) was performed to measure lean mass, body fat and hydration status. Overhydration was considered if TBW value was above [Combining Acute Accent]normal range[Combining Acute Accent]. Results: Study group of 89pts, 61.8% male, mean age 60.9 ± 17.7 years [range 21–92], 85.4%HTN (treated with a mean 1.8 ± 1.2 antihypertensive drugs), 75.3% had body mass index (BMI) above 25 kg/m2; 29.8% Diabetics; 28.2% had CVD, 15.7% had blood pressure measured at the time of BIA above 140/90mmHg and 12.2% had peripheral edema. Median eGFR was 43 mL/min, Interquartile range: 29.8–80.9 mL/min. 37.9% class I/II, 28.7% class III, 18.4% class IV and 14.9% had CKD class V. Median percent body fat (PBF) beyond [Combining Acute Accent]normal[Combining Acute Accent] was 33.2%, IQR:3.75–57% (range: -46% to 112%). Mean ECW/TBW ratio was 38.29 ± 1.2% [range: 35–41%]. Table 1 shows pt population data according to HTN diagnosis. Hypertensive pts were significantly older, had lower eGFR and higher prevalence of extracellular water above [Combining Acute Accent]normal[Combining Acute Accent]. In a multivariate analysis, hypertension was independently and negatively correlated with eGFR (OR = 0.963; 95%CI: 0.938–0.988; p = 0.004) and positively correlated with overhydration (OR = 1.366; 95%CI: 1.03–1.810; p = 0.03). The model was adjusted to: age, gender, diabetes, BMI, cardiovascular disease and PBF. Figure. No caption available. Conclusions: In this group of CKD patients, hypertension was associated with higher hydration status evaluated by BIA. Although BMI was slightly higher in hypertensive patients, hypertension was not associated with visceral fat area or body fat mass. Current clinical BMI evaluation may be insufficient to evaluate these patients and new methods to measure body water content seem to be required.