Dépistage de la maladie rénale chronique chez le sujet hypertendu : enquête sur la recherche des marqueurs urinaires d'atteinte rénale en médecine générale

Background: Screening for Chronic kidney disease (CKD) is recommended in hypertensive patients by French and international guidelines. Whereas serum creatinine concentration for estimating glomerular filtration rate (GFR) is commonly prescribed by general practitioners (GPs), there is little information on the search for urinary markers of kidney damage. The aim of our study was to evaluate the use of urinalysis for the management of hypertensive patients, in primary care. Method: An electronic questionnaire was sent to 223 GPs selected by draw in the Isère phone book. Results: Among the 78 GPs who answered, 77% had been provided information on screening for CKD in hypertensive patients. Respectively, 14% and 51% of GPs considered that they systematically search for hematuria and proteinuria at the time of hypertension diagnosis. 36% of GPs were found to search regularly for proteinuria in the follow up management of hypertensive patients. In the 47% of GP's that assumed searching for microalbuminuria in hypertensive patients, for 92% of them the aim was to assess a renal risk, whereas 46% were interested in cardiovascular risk assessment. In our study, 83% of GPs owned urinary dipstick, but only 25% used them as a screening test. GPs' awareness was positively associated with a better search for proteinuria. Conclusion: GPs have a moderate interest for urinary markers of kidney damage. French guidelines on hypertension should emphasize the importance of albuminuria in the monitoring of hypertensive patients. ; Contexte : Le dépistage de la maladie rénale chronique (MRC) est recommandé chez les sujets hypertendus, en France et au niveau international. Alors que la mesure de la créatininémie qui permet d'estimer le débit de Filtration glomérulaire (DFG) est un examen largement prescrit par les médecins généralistes (MG), il existe peu d'informations concernant la recherche des marqueurs urinaires d'atteinte rénale. L'objectif de notre enquête était d'établir un état des lieux de la pratique de ces examens ...