Recognizing occult renal disease in managed hypertensives

Abstract

Introduction Occult renal disease (ORD) is a condition that characterizes the early stages of kidney disease, which cannot be detected by routine monitoring such as serum creatinine only. The objective of this study was to determine the prevalence of ORD in managed hypertensives in a tertiary health care center in South Nigeria. Participants and methods A cross-sectional retrospective was carried out in 708 managed hypertensives attending the medical outpatient clinic. Data from 826 patients were analyzed, and 706 (85.7%) of these patients were found to have a creatinine value of 1.5 mg/dl and less. These 708 managed hypertensives with a normal serum creatinine value were analyzed, and their estimated glomerular filtration rate (eGFR) calculated with the Chronic Kidney Disease Epidemiology (CKD_EPI) prediction equation. Results A total of 218 (30.9%) had an eGFR lower than 60 ml/min,244(34.6%) had an eGFR of 60–89 ml/min, and the remaining 244 (34.6%) had an eGFR of 90 ml/min and above. Conclusion ORD has a high prevalence of 31% in treated hypertensive patients with normal serum creatinine values of less than 1.5 mg/dl. There is a need to use eGFR values, in this case, the CKD-EPI to assess GFR, to enable physicians detect chronic kidney disease at an earlier stage than the current practice of using serum creatinine alone. This is important as it appears that serum creatinine alone grossly underestimates the presence of CKD in treated hypertensive patients.