Evaluation of the efficiency of nephroprotective therapy in patients with chronic kidney disease and arterial hypertension

Background. In recent years, there has been an increase in patients with an established diagnosis of chronic kidney disease (CKD) at late stages. Disease progression forces the transition to dialysis therapy.

Objective. Evaluation of the effectiveness of the therapy used for patients with an established diagnosis of CKD (stage C1–C3b) and arterial hypertension (AH), taking into account the stratification of the risk of adverse events.

Material and methods. A retrospective analysis of case histories of patients diagnosed with CKD in outpatient medical institutions of Tyumen was performed. Inclusion criteria: patients with CKD stages C1–C3b and arterial hypertension, regularly receiving therapy prescribed by a nephrologist and cardiologist. When assessing the probability of an outcome, taking into account the presence of risk factors (comorbidities), the relative risk was calculated. Differences were considered statistically significant at a two-sided significance level of P<0.05, the minimum reliability of differences was 95%.

Results. According to the data obtained, the risk of an unfavorable outcome was higher in patients over 55 years of age in the 1st group receiving monotherapy with ACE inhibitors/ARBs compared to the 2nd group, initially receiving combination therapy - ACE inhibitors/ARBs in combination with a diuretic or calcium channel blockers (P=0.015), the odds ratio when comparing the two groups was 1.38.

Conclusion. Nephroprotective therapy can reduce the incidence of disease progression and thereby improve the quality of life and life expectancy of patients with CKD. Combination therapy demonstrates its greater effectiveness compared to monotherapy in patients with CKD.