Evaluación de la función renal en pacientes hipertensos: subdiagnóstico de la enfermedad renal

background hypertensive patients demonstrate a higher risk of renal failure, an independent risk factor in the development of cardiovascular disease. serum creatinine concentration is a poor indicator as to estimate glomerular filtration rate, which leads to an underestimation of renal failure. work objective to compare the prevalence of renal failure among hypertensive patients by means of two different methodologies: a) using the abbreviated equation taken from the "modification of diet in renal disease" (mdrda) study and b) isolated serum creatinine values. research design and methods seven hundred and fifty-two medical records from hypertensive patients were evaluated. glomerular filtration rate was estimated using the abbreviated equation from the mdrda study and serum creatinine was evaluated by means of the modified jaffé method. results one hundred and forty five patients (19.3%) had a glomerular filtration rate less than 60 ml/min/1.73 m2 according to mdrda. only 33.8% of these (49 patients) showed high serum creatinine, representing 6.5 % of the total of patients (p = 0.001). age, prevalence of male sex, type 2 diabetes with proteinuria and systolic blood pressure were significantly higher in patients with renal disease. conclusion the present study demonstrates that the same hypertensive patients show a different prevalence of renal dysfunction according to which method was used in the evaluation. the use of mdrda showed a prevalence of 19.3% in renal failure; however, the evaluation of isolated plasmatic creatinine concentration indicated only 6.5% of the patients presented renal failure, which clearly proves that the latter method is insufficient to evaluate renal function.