Abstract: Objective  To systematically review the prevalence of apparent treatment resistant hypertension (aTRH) in non-dialysis patients with chronic kidney disease (CKD).  Methods  Chinese and English databases were searched for observational studies on the prevalence of aTRH in non-dialysis patients with CKD. According to the American Heart Association (AHA) criteria, aTRH was defined as AHA-1 and AHA-2. Stata 15.0 was used for the meta-analysis of overall and staged prevalence of CKD under different aTRH definitions.  Results A total of 14 studies were included. The overall prevalence of aTRH in CKD patients was 27.1% (ES=0.271, 95% CI: 0.220~0.321, P＜0.001). Under AHA-1 definition, the prevalence of aTRH in CKD1-5 patients was 20.6% (ES=0.206, 95% CI: 0.105~0.307, P＜0.001), and the prevalence of aTRH in CKD3-5 patients was 29.5% (ES=0.295, 95% CI: 0.224~0.366, P＜0.001). Under AHA-2 definition, the prevalence of aTRH in CKD1-5 patients was 30.4% (ES=0.304, 95% CI: 0.178~0.430, P＜0.001). The prevalence of aTRH in CKD patients increased with the decrease of glomerular filtration rate in all original studies.  Conclusion The prevalence of aTRH in non-dialysis CKD patients is high and increases with the progression of renal injury. More attention should be paid to aTRH in CKD patients. 

Key words: Chronic kidney disease, Resistant hypertension