Author(s)

Guillaume Mahamat Abderraman^1*, Ali Adam Ahamat², Charfadine Senousssi¹, Doune Narcisse², Mahamat Hissein Ali¹, Adamou Abbassi Mana³, Yusra Aboulbachar¹, Mirene Bourdjo¹

¹Service de Néphrologie, CHU la Renaissance de N’Djamena, N’Djamena, Tchad.
²Service de Cardiologie, CHU la Renaissance de N’Djamena, N’Djamena, Tchad.
³Service de Réanimation, CHU la Renaissance de N’Djamena, N’Djamena, Tchad.

Introduction: Arterial hypertension is frequently encountered in patients with chronic renal failure. Whether primary or secondary to kidney disease, hypertension remains an important risk factor not only for the progression of kidney disease but also for the occurrence of cardiovascular events. Currently, there is no data on the control of hypertension in CKD patients in Chad. The main objective of this study was to determine the factors of poor control of hypertension during CKD and their therapeutic modalities. Methodology: This is a cross-sectional, descriptive and analytical study carried out over a period of 8 months from September 1, 2021 to May 31, 2022 in the Nephrology Department of the Renaissance University Hospital Center in N’Djamena, Chad. During the study period, patients aged 18 years and above, which were hospitalized and/or followed for CKD with uncontrolled hypertension were included. Results: A total of 1013 patients were consulted during the study period, however, 36 cases were included, with a hospital prevalence of 3.5%. The mean age of the patients was 60 ± 9.68 years [22 and 75 years]. The patient’s history was dominated by hypertension (94.4%) and diabetes (41.7%). The main risk factors of hypertension found were diabetes (38.9%), physical inactivity (19.4%) and obesity (36.1%). Type 2 diabetes was pre-sent in 38.9% (n = 14) of the patients. There was a statistical relationship between unbalanced diabetes and poor blood pressure control (p < 0.001). Grade 1, 2 and 3 hypertension accounted for 47.2% (n = 17), 25% (n = 9) and 27.8% (n = 10), respectively. According to the GFR estimate, 12 patients (33.3%) had stage 3 chronic kidney disease, 13 patients (36.1%) had stage 4 chronic kidney disease and 11 patients (30.6%) had stage 5 chronic kidney disease. 18 patients (50%) were treated with monotherapy, 15 patients (41.7%) were treated with dual therapy with at least one included an angiotensin II receptor blocker, at least one molecule was a blocker of the renin-angiotensin system and 3 patients (8.3%) were treated using a triple antihypertensive therapy. The factors involved with poor control of hypertension were the grade of hypertension (p = 0.036), monotherapy (p = 0.042), stages 4 and 5 of CKD (p = 0.011) and dilation of the heart chambers (p < 0.001). Conclusion: Patients with chronic renal failure are at a risk of developing hypertension. Good control of blood pressure prevents deterioration of kidney function.

Hypertension, Chronic Kidney Disease, Chad

Abderraman, G. , Ahamat, A. , Senousssi, C. , Narcisse, D. , Ali, M. , Mana, A. , Aboulbachar, Y. and Bourdjo, M. (2023) Factors Associated with Poor Control of Hypertension in Patients with Non-Dialysis Chronic Renal Failure. Open Journal of Nephrology, 13, 201-210. doi: 10.4236/ojneph.2023.133019.