Assessing the Impact of Chronic Hypertension on Renal Function: A Cross-Sectional Study

Abstract

Background: Chronic hypertension is a leading cause of chronic kidney disease (CKD) progression and is associated with significant morbidity and mortality. The relationship between hypertension and renal function is complex, involving multiple pathophysiological mechanisms that contribute to the worsening of kidney function over time. Objective: This study aimed to assess the impact of chronic hypertension on renal function among CKD patients in a tertiary care hospital in Khulna, Bangladesh, from June to December 2023. Methods: A cross-sectional study was conducted involving 190 patients with chronic hypertension who were undergoing regular follow-up. Data on demographic characteristics, clinical history, and renal function tests were collected and analyzed. Statistical analysis was performed to identify associations between hypertension-related factors and renal function decline. Results: The mean age of the participants was 53.4 ± 9.2 years, with the majority (45.8%) aged between 50-59 years. The mean age of onset of hypertension was 42.7 ± 7.1 years. Among the participants, 78.4% were on regular antihypertensive medication, and 62.6% had controlled blood pressure. Sleep disturbances were reported by 54.2% of the patients, and 40% had a history of smoking. A significant proportion (36.3%) of participants had a history of diabetes. The mean BMI was 27.3 ± 4.5 kg/m². Renal function tests revealed that 32.1% of patients had an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m². Statistical analysis showed that uncontrolled blood pressure (p<0.001), smoking history (p=0.002), and diabetes (p<0.001) were significantly associated with reduced renal function. Conclusion: This study demonstrates that chronic hypertension, particularly when poorly controlled, significantly impacts renal function in CKD patients. Factors such as smoking, diabetes, and sleep disturbances further exacerbate the decline in renal function. Effective management of hypertension, along with addressing modifiable risk factors, is crucial in slowing the progression of CKD and improving patient outcomes.