title: Prevalence and characteristics of patients with resistant hypertension and chronic kidney disease.
abstract: Resistant hypertension (RH) is a common problem in patients with chronic kidney disease (CKD). A decline in the glomerular filtration rate (GFR) and increased albuminuria are associated with RH; however, there are few published studies about the prevalence of this entity in patients with CKD.
  
  
  OBJECTIVE
  To estimate the prevalence of RH in patients with different degrees of kidney disease and analyse the characteristics of this group of patients.
  
  
  METHODS
  A total of 618 patients with hypertension and CKD stages i-iv were enrolled, of which 82 (13.3%) met the criteria for RH.
  
  
  RESULTS
  RH prevalence increased significantly with age, the degree of CKD and albuminuria. The prevalence of RH was 3.2% in patients under 50 years, 13.8% between 50-79 years and peaked at 17.8% in patients older than 80 years. Renal function prevalence was 4, 15.8 and 18.1% in patients with an estimated glomerular filtration rate (GFR) of > 60, 30-59 and < 30ml/min/1.73 m2, respectively, and 8.9, 15.9 and 22.5% for a urine albumin to creatinine ratio (UACR) < 30, 30-299 and > 300mg/g respectively. In a logistic regression model, the characteristics associated with resistant hypertension were age, history of cardiovascular disease, GFR, albuminuria and diabetes mellitus. A total of 47.5% of patients with resistant hypertension had controlled BP (<140/90mmHg) with 4 or more antihypertensive drugs. These patients were younger, with better renal function, less albuminuria and received more aldosterone antagonists.
  
  
  CONCLUSIONS
  RH prevalence increases with age, the degree of CKD and albuminuria. Strategies such as treatment with aldosterone receptor antagonists are associated with better blood pressure control in this group of patients, leading to reduced prevalence.
authors.affiliation: Departamento Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, España. Electronic address: ursulaverdalles@yahoo.es.
authors.forename: Úrsula
authors.initials: Ú
authors.lastname: Verdalles
authors.affiliation: Departamento Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors.forename: Marian
authors.initials: M
authors.lastname: Goicoechea
authors.affiliation: Departamento Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors.forename: Soledad
authors.initials: S
authors.lastname: Garcia de Vinuesa
authors.affiliation: Departamento Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors.forename: Borja
authors.initials: B
authors.lastname: Quiroga
authors.affiliation: Departamento Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors.forename: Isabel
authors.initials: I
authors.lastname: Galan
authors.affiliation: Departamento Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Verde
authors.affiliation: Departamento Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors.forename: Ana
authors.initials: A
authors.lastname: Perez de Jose
authors.affiliation: Departamento Nefrología, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors.forename: José
authors.initials: J
authors.lastname: Luño
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000150:complications*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D051436:Renal Insufficiency, Chronic / Q000150:complications*; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Chronic kidney disease; Diuretics; Diuréticos; Enfermedad renal crónica; Espironolactona; Hipertensión resistente; Prevalence; Prevalencia; Resistant hypertension; Spironolactone