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Antihypertensive Treatment Patterns in CKD Stage 3 and 4: The CKD-REIN Cohort Study

dc.rights.licenseopenen_US
hal.structure.identifierCentre de recherche en épidémiologie et santé des populations [CESP]
dc.contributor.authorCOSTES-ALBRESPIC, Margaux
hal.structure.identifierMécanismes physiopathologiques et conséquences des calcifications cardiovasculaires - UR UPJV 7517 [MP3CV]
hal.structure.identifierCHU Amiens-Picardie
dc.contributor.authorLIABEUF, Sophie
hal.structure.identifierCHU Amiens-Picardie
hal.structure.identifierMécanismes physiopathologiques et conséquences des calcifications cardiovasculaires - UR UPJV 7517 [MP3CV]
dc.contributor.authorLAVILLE, Solène
hal.structure.identifierAgence de la biomédecine [Saint-Denis la Plaine]
hal.structure.identifierSexualité et soins (Genre, Sexualité, Santé) [CESP - INSERM U1018 - Equipe 7]
dc.contributor.authorJACQUELINET, Christian
hal.structure.identifierBioingénierie tissulaire [BIOTIS]
dc.contributor.authorCOMBE, Christian
hal.structure.identifierCardiovasculaire, métabolisme, diabétologie et nutrition [CarMeN]
hal.structure.identifierCentre Hospitalier Lyon Sud [CHU - HCL] [CHLS]
dc.contributor.authorFOUQUE, Denis
hal.structure.identifierCardiovasculaire, métabolisme, diabétologie et nutrition [CarMeN]
hal.structure.identifierAssociation pour l'Utilisation du Rein Artificiel Région Lyonnaise [AURAL]
dc.contributor.authorLAVILLE, Maurice
hal.structure.identifierCentre Hospitalier Régional Universitaire de Nancy [CHRU Nancy]
dc.contributor.authorFRIMAT, Luc
hal.structure.identifierPontifícia Universidade Católica do Paraná [Curitiba, Brasil] = Pontifical Catholic University of Paraná [Curitiba, Brazil] = Université catholique pontificale du Paraná [Curitiba, Brésil] [PUCPR]
hal.structure.identifierArbor Research Collaborative for Health
dc.contributor.authorPECOITS-FILHO, Roberto
hal.structure.identifierCentre de recherche en épidémiologie et santé des populations [CESP]
dc.contributor.authorLAMBERT, Oriane
hal.structure.identifierCentre de recherche en épidémiologie et santé des populations [CESP]
hal.structure.identifierService Néphrologie/Dialyse [AP-HP Ambroise-Paré]
dc.contributor.authorMASSY, Ziad
hal.structure.identifierCentre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
dc.contributor.authorSAUTENET, Bénédicte
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorALENCAR DE PINHO, Natalia
hal.structure.identifierCardiovasculaire, métabolisme, diabétologie et nutrition [CarMeN]
hal.structure.identifierCentre Hospitalier Lyon Sud [CHU - HCL] [CHLS]
dc.contributor.authorFOUQUE, Denis
hal.structure.identifierCentre Hospitalier Régional Universitaire de Nancy [CHRU Nancy]
dc.contributor.authorFRIMAT, Luc
hal.structure.identifierService d'Epidémiologie et de Santé Publique [Lille]
dc.contributor.authorHAMROUN, Aghilès
hal.structure.identifierAgence de la biomédecine [Saint-Denis la Plaine]
hal.structure.identifierSexualité et soins (Genre, Sexualité, Santé) [CESP - INSERM U1018 - Equipe 7]
dc.contributor.authorJACQUELINET, Christian
hal.structure.identifierCardiovasculaire, métabolisme, diabétologie et nutrition [CarMeN]
hal.structure.identifierAssociation pour l'Utilisation du Rein Artificiel Région Lyonnaise [AURAL]
dc.contributor.authorLAVILLE, Maurice
dc.contributor.authorOMOROU, Abdou
dc.contributor.authorPASCAL, Christophe
dc.contributor.authorPECOITS-FILHO, Roberto
dc.contributor.authorSTENGEL, Bénédicte
dc.contributor.authorLANGE, Céline
dc.contributor.authorLAMBERT, Oriane
dc.contributor.authorMETZGER, Marie
dc.date.accessioned2024-10-29T09:39:44Z
dc.date.available2024-10-29T09:39:44Z
dc.date.issued2024-10-01
dc.identifier.issn2590-0595en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/202944
dc.description.abstractEnRationale & ObjectiveBlood pressure (BP) control is essential for preventing cardiorenal complications in chronic kidney disease (CKD), but most patients fail to reach BP target. We assessed longitudinal patterns of antihypertensive drug prescription and systolic BP (SBP).Study DesignProspective observational cohort studySetting & Population2755 hypertensive patients with CKD stages 3–4, receiving care from a nephrologist, from the French CKD-REIN cohort studyExposurePatient factors, including sociodemographic characteristics, medical history, and laboratory data, and provider factors, including number of primary-care physician and specialist encounters.OutcomesChanges in antihypertensive drug class prescription during follow-up: add-on, or withdrawal.Analytical ApproachHierarchical shared-frailty models to estimate hazard ratios (HR) to deal with clustering at the nephrologist level, and linear mixed models to describe Systolic BP trajectory.ResultsAt baseline, median age was 69, mean eGFR, 33 ml/min/1.73m2; 66% of patients were men, 81% had BP ≥130/80 mmHg and 75% were prescribed ≥2 antihypertensive drugs. During a median 5-year follow-up, the rate of changes of antihypertensive prescription was 50 per 100 person-years, 23 per 100 for add-ons and 25 per 100 for withdrawals. After adjusting for risk factors, Systolic BP, and the number of antihypertensive drugs, poor medication adherence was associated with increased HR for add-on, 1.35 (95% confidence interval, 1.01-1.80), while a shorter education level was associated with increased HR for withdrawal, 1.23 (1.02-1.49) for 9-11 years versus ≥12 years. More frequent nephrologist visits (≥4 versus none) were associated with higher HRs of add-on and withdrawal (1.52; 95% CI 1.06-2.18 and 1.57; 1.12-2.19, respectively), while associations with visit frequency to other physicians varied with their specialty. Mean Systolic BPdecreased by 4 mmHg following drug add-on but tended to rise thereafter.LimitationsLack of information on prescriber, and drug dosing.Conclusions: In patients with CKD and poor BP control, changes in antihypertensive drug prescriptions are common and relate to clinician preferences and patients’ tolerability. Sustainable reduction in Systolic BPafter add-on of a drug class is infrequently achieved.
dc.language.isoENen_US
dc.subject.enchronic kidney disease
dc.subject.enhypertension
dc.subject.enblood pressure
dc.subject.enantihypertensive agents
dc.subject.enrenin-angiotensin system
dc.title.enAntihypertensive Treatment Patterns in CKD Stage 3 and 4: The CKD-REIN Cohort Study
dc.title.alternativeKidney Meden_US
dc.typeArticle de revueen_US
dc.identifier.doi10.1016/j.xkme.2024.100912en_US
dc.subject.halSciences du Vivant [q-bio]/Médecine humaine et pathologie/Urologie et Néphrologieen_US
bordeaux.journalKidney medicineen_US
bordeaux.page100912en_US
bordeaux.hal.laboratoriesBordeaux Population Health Research Center (BPH) - UMR 1219en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionINSERMen_US
bordeaux.institutionCNRS
bordeaux.institutionCHU de Bordeaux
bordeaux.institutionInstitut Bergonié
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
bordeaux.import.sourcehal
hal.identifierhal-04731989
hal.version1
hal.popularnonen_US
hal.audienceInternationaleen_US
hal.exportfalse
workflow.import.sourcehal
dc.rights.ccPas de Licence CCen_US
bordeaux.COinSctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=Kidney%20medicine&rft.date=2024-10-01&rft.spage=100912&rft.epage=100912&rft.eissn=2590-0595&rft.issn=2590-0595&rft.au=COSTES-ALBRESPIC,%20Margaux&LIABEUF,%20Sophie&LAVILLE,%20Sol%C3%A8ne&JACQUELINET,%20Christian&COMBE,%20Christian&rft.genre=article


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