Accuracy in the diagnosis of hypertension and CKD is key to determine their possible association

Excerpt

Dear authors Wang M. et al. Congratulations on the article recently published in the journal Endocrine on the relationship between Arterial Hypertension and Chronic Kidney Disease [1]. I would like to take the liberty of making a general comment on your work by way of criticism, not so much methodological as substantive. Following the consensus document recently published in the journal Nefrología on the diagnosis and management of CKD endorsed by nine medical societies [2]. And based on the recommendations of the KDIGO guidelines followed in our country by nephrologists and primary care physicians [3]. I must comment that to make the diagnosis of CKD we must be guided by three parameters (any of them separately, two or all three), filtration rate below 60 ml/min/1.73 m², albumin creatinine ratio (ACC) greater than 30 mg/g or evidenced renal organic damage, all of them during 90 days and with a determined clinical repercussion independently of the cause of this. Following the aforementioned guidelines, it is clear that early diagnosis is key to avoid progression. Progression is also defined as the loss of 5 ml/min/1.73 m² in 1 year, 10 ml/min/1.73 m² in 5 years or 25% with respect to baseline. Increase in CAC of 50% or jump in stage. HTN is among the risk factors for CKD, it is among the factors for the onset of CKD, and above all, poorly controlled and refractory HTN is among the risk factors for progression. Finally, in the case of resistant HT (>3 drugs), it clearly conditions referral to nephrology for study and treatment. …