![]() The aim of the study was to define the rates and the determinants of hypertension, uncontrolled hypertension, and apparent treatment‐resistant hypertension in a population of patients with CKD who underwent thorough renal explorations, including gold standard measurement of glomerular filtration rate (GFR) and ECW. 7 Several small‐scaled studies have suggested that volume overload plays a key role for hypertension control during CKD, 11, 12 but extracellular water (ECW) was estimated, using multifrequency bioimpedance, as the most direct and accurate method to measure extracellular fluid volume and isotope dilution however, this measurement is cumbersome and not routinely available. ![]() 9, 10 Few data on the factors associated with hypertension control and resistance were obtained specifically in patients with CKD. ![]() 6, 7, 8 Most epidemiological studies on treatment and control of hypertension were conducted in cohorts meant to be representative of the general population, such as the National Health and Nutrition Examination Surveys (NHANESs). High rates of uncontrolled hypertension and resistant hypertension, both associated with a poor cardiovascular and renal prognosis, 1, 2, 3, 4, 5 have been reported in patients with chronic kidney disease (CKD). Extracellular water, older age, lower glomerular filtration rate, higher albuminuria and body mass index, male sex, African origin, diabetes mellitus, and diabetic and glomerular nephropathies were associated with resistant hypertension. In multivariable analysis, extracellular water, older age, higher albuminuria, diabetic nephropathy, and the absence of aldosterone blockers were independently associated with uncontrolled BP. Among hypertensive patients, 44% and 32% had uncontrolled (≥140/90 mm Hg) and resistant (uncontrolled BP despite 3 drugs, including a diuretic, or ≥4 drugs, including a diuretic, regardless of BP level) hypertension, respectively. In 2015 patients (mean age, 58.7☑5.3 years 67% men mean glomerular filtration rate, 42☑5 mL/min per 1.73 m 2), prevalence of hypertension was 88%. Hypertension was defined as blood pressure ( BP average of 3 office measurements) ≥140/90 mm Hg or the use of antihypertensive drugs. We analyzed baseline data from patients with CKD stage 1 to 5 (NephroTest cohort) who underwent thorough renal explorations, including measurements of glomerular filtration rate (clearance of 51Cr‐EDTA) and of extracellular water (volume of distribution of the tracer).
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