Renal impairment in elderly patients with hypertension and diabetes

Abstract

We investigated the prevalence of renal impairment in individuals with known hypertension or diabetes aged 50-75 years in two South London General Practices. We initially interrogated the practice and hospital biochemistry databases for each individual's most recent serum creatinine. Individuals with no result recorded in the previous year were then invited for screening: 189/365 (51.8%) attended. Data were collected on 821 of a total potential population of 997. Taking a serum creatinine of 120 mmol/l as the upper limit of normal, the overall prevalence of renal disease in this population was 8.4%: 6.1% in the hypertensives, 12.6% in the diabetics and 16.9% in those with both. Significant proteinuria (≥ 2 +) was present in 3.9% of the total population: 2.2% of hypertensives, 8.3% of diabetics and 3.9% of those with both. At screening, 44.5% of individuals had inadequately controlled blood pressure. Renal impairment is common in this population at high risk of renal disease. Screening for renal disease in this population is simple, safe and gives a high yield of positive results.