Lesão renal em doentes com hipertensão arterial: estudo em cuidados de saúde primários na região de Braga

Pedro Costa, Médico interno de Medicina Geral e Familiar. USF Maxisaúde, ACeS do Cávado I, Braga, Andreia Ramôa, Médica interna de Medicina Geral e Familiar. USF Gualtar, ACeS do Cávado I, Braga
2018 Revista Portuguesa de Clínica Geral  
A s doenças cardiovasculares são a principal causa de morbimortalidade em Portugal. A hipertensão arterial (HTA), que atinge cerca de 42% da população adulta portuguesa, é um dos principais fatores de risco para a ocorrência de eventos cerebrovasculares, coronários, insuficiência cardíaca e renal. 1 A estratificação do risco cardiovascular e a deteção precoce de lesão de órgão alvo são essenciais para orientar o tratamento de indivíduos com HTA. Um dos órgãos mais frequentemente atingidos pela
more » ... oença hipertensiva é o Rev Port Med Geral Fam 2018;34:242-6 Recebido em 28-09-2016 Aceite para publicação em 11-04-2018 Rev Port Med Geral Fam 2018;34:242-6 246 artigosbreves ABSTRACT RENAL DAMAGE IN HYPERTENSIVE PATIENTS: PRIMARY HEALTHCARE UNITS STUDY IN BRAGA REGION Introduction: Hypertension maybe cause or consequence of chronic kidney disease (CKD). High blood pressure can change albumin excretion rate and/or lead to more rapid decline of glomerular filtration rate (GFR). Objetive: Determine the prevalence of the microalbuminuria (MA) and CKD in patients with hypertension of two Northern Portuguese Primary Health Care Providers. Verify the relationship between individual factors and MA/CKD. Methods: Adults diagnosed with arterial hypertension were included in this study. Data collection from MIM@UF and SClínico programs, during 2015. Variables: age, gender, body weight, blood pressure control, length of disease, diabetes mellitus and renin angiotensin inhibitor drugs users. Then a binary logistic regression model was created to identify possible risk factors associated with MA and CKD. Results: The study included 310 individuals with arterial hypertension, mostly women (51,9%) with average age of 68,1 years. MA was present in 10,6%, preferentially determined by 24 hours urine collection (54,5%). The prevalence of CKD with GFR <60ml/min was 22,6%. We found statistical correlation with MA and overweight (p=0,046), male (p=0,035) and no treatment with renin angiotensin inhibitors (p=0,034). The increased age and overweight/obesity are associated with CKD (GFR<60ml/min). Discussion: Renal damage is present in an important proportion of hypertensive people followed up in primary care. The family doctor has an important role in early detection of renal lesion and with the appropriate screening methods, should be able to recognize the modifiable risk factors for preventing progression of renal disease.
doi:10.32385/rpmgf.v34i4.12484 fatcat:gmz3donwojb6vlebfzmiprrnwm