Retrospective cohort study on the relationship between hypertension and chronic kidney disease in the elderly / 公共卫生与预防医学

ABSTRACT

Objective To analyze the effect of dynamic changes of hypertension on the incidence of chronic kidney disease (CKD) in the elderly aged 65 and over. Methods A retrospective cohort study was conducted. A total of 419 patients with hypertension without other organic diseases diagnosed in the outpatient department of our hospital from March 2015 to September 2018 were used as the exposure group, and non-hypertensive patients with other diseases in the same period were used as the control group. In December 2020, 269 patients with complete clinical data in the cohort were finally included. The collected information includes gender, age, blood pressure, 24-hour urinary protein and blood creatinine. According to the level of serum creatinine, the glomerular filtration rate of patients was estimated for CKD stage (stage 1-5). According to the level of diastolic blood pressure and systolic blood pressure, patients were divided into mild, moderate and high levels of hypertension. The incidence and outcome of CKD in the two groups were compared. Results After median follow-up of 3.50 years , 53 cases of new CKD patients aged 65 and above were found. The cumulative incidence rate was 19.70%, and the incidence density was 56.71/1 000 years (95% CI 53.29 - 59.83 ). Cox regression showed that the level of hypertension in the elderly was positively correlated with the risk of CKD (HR > 1); At the same time, the risk of CKD increased with the stage of blood pressure. After stratified by gender, age and other factors, there was still a significant positive correlation between hypertension and chronic kidney disease. In addition, the effect of hypertension on chronic kidney disease in elderly men was significantly higher than that in women. Conclusion There is a significant correlation between the changes of hypertension and the progress of chronic kidney disease in the elderly population, especially men. We should pay attention to the control of blood pressure in the elderly population and delay the progress of CKD.