HYPERTENSION AS A RISK FACTOR FOR MORTALITY AND THE DEVELOPMENT OF CHRONIC KIDNEY DISEASE AFTER AN EPISODE OF ACUTE KIDNEY INJURY WITH FULL RECOVERY

Objective: Acute kidney injury (AKI) is a real public health problem due to its severity and its consequences in the short, medium and long term. Hypertension is a very common disease in our country. So our objective was to evaluate if hypertension was a real major risk factor of mortality among patients fully recovered from AKI. Design and method: We undergone a retrospective study which was carried out in the nephrology department of Fattouma Bourguiba hospital in Monastir. We included patients who had an AKI with full recovery who had been hospitalized between January 2002 and December 2015. Our study aimed to assess the impact of hypertension on mortality and the development of chronic kidney disease (CKD) after an episode of AKI. Results: Our population was made up of 107 men and 107 women, median age was 61 years and 42.1% had multiple comorbidities. Pre renal AKI represented the predominant mechanism which was retained in our study with a rate of 52.3% and dehydration as the main aetiology in 105 patients. In the short term, 25 patients had progressed to CKD. The mean overall survival in our study was 159 months with a high risk of mortality in elderly (patients aged > 65 years), who had multiple comorbidites, hypertensive (p = 0.007), diabetics, with vascular disease, Charlson Cmorbidity index > 5, who presented with hyperkaleamia > 5.5 and pre renal mechanism of the AKI episode. Hypertensive patients had 3 times the risk of cardiovascular death and 4 times risk of developping CKD comparing to patients with normal blood pressure. Conclusions: Hypertension is a real public health problem impacting the short, medium and long term prognosis of patients who have had an episode of AKI with full recovery. Prevention and diagnosis of hypertension remain a global issue and our study demonstarted that hypertension is also a risk factor of mortality and development of CKD.