DOI: http://dx.doi.org/10.18203/2319-2003.ijbcp20211015

Type of antihypertensive medications in CKD-stage V patients on hemodialysis and its relationship with demographic variables: an observational study

Kalpana Bharani, Rajesh Bharani, Rubina Vohra, Chhaya Goyal, Pooja Reddy

Abstract


Background: The majority of the patients with chronic kidney disease stage V on hemodialysis have been found to have hypertension and many studies have recommended that hypertension should be essentially controlled in these patients for better clinical outcome. But till now no study analyzing the relationship between antihypertensive medication and the demographics of the patient has been done, so with this objective in mind the present study was carried out. Aim and objectives were to analyse the types of antihypertensive being used in CKD stage V patients on hemodialysis and their relationship with the demographic variables.

Methods: The present observational cross-sectional study was conducted in Sri Aurobindo Institute of Medical Sciences, Indore (M.P.) from 01 January 2018 to 31 March 2018 on patients with chronic kidney disease stage V on hemodialysis. The demographic variables evaluated were age, sex, basic disease and duration of dialysis. The relationship with type of antihypertensive being used and these demographic variables was calculated using Pearson Chi-square test. A p value of<0.05 was taken as statistically significant.

Results: Diabetic nephropathy, CIN-CKD 5d, CGN-CKD 5d and hypertensive nephropathy were the commonest basic diseases in our study. Calcium channel blockers, beta blockers, ATRB, centrally acting antihypertensive, ACE inhibitors were the commonest antihypertensive used. Statistically significant relationship was seen between antihypertensive and basic disease (p<0.05).

Conclusions: The study revealed that all the antihypertensive medications are prescribed on the basis of basic disease while other demographic variables do not play a vital role prescribing antihypertensive in patients with CKD stage V on haemodialysis. And the prescription of antihypertensive medications also matches with the actual clinical practice.


Keywords


Hypertension, Chronic kidney disease, End stage renal disease, Hemodialysis, Antihypertensive use, Association between antihypertensive used and demographic variables

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References


Lewington S, Clarke R, Qizilbash N, Peto R, Collins R; Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002;360(9349):1903-13

Agarwal R, Andersen MJ, Bishu K, Saha C. Home blood pressure monitoring improves the diagnosis of hypertension in hemodialysis patients. Kidney Int. 2006;69(5):900-6.

Malliara M. The management of hypertension in hemodialysis and CAPD patients. Hippokratia. 2007;11(4):171-4.

Joseph N, Yogananda R, Bharathi DR, Padman V, Sandeep GN. A study on prescription pattern of antihypertensive agents in chronic renal failure patients and assessment of medication adherence. Int J Pharm Sci Rev Res 2017;45(2):72-5.

Lee S, Oh HJ, Lee EK, Lee O, Ha E, Kim SJ, et al. Blood Pressure Control During Chronic Kidney Disease Progression. Am J Hypertens. 2017;30(6):610-16.

Bhanu PB, Basavanna PL. Pattern of antihypertensive drug utilisation among chronic kidney disease patients in a dialysis unit of a tertiary care hospital. Int J Biomed Res. 2015;6(04):251-4.

Saju AP, Edakkarayil AC, Maheswari E, Gurudev KC. Prescribing pattern and cost effectiveness analysis of antihypertensive drugs in chronic kidney disease patients. Europ J Pharmaceut Med Res. 2016;3(1):219-25.

Lewington S, Clarke R, Qizilbash N, Peto R, Collins R; Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002;360(9349):1903-13

Agarwal R, Andersen MJ, Bishu K, Saha C. Home blood pressure monitoring improves the diagnosis of hypertension in hemodialysis patients. Kidney Int. 2006;69(5):900-6.

Malliara M. The management of hypertension in hemodialysis and CAPD patients. Hippokratia. 2007;11(4):171-4.

Joseph N, Yogananda R, Bharathi DR, Padman V, Sandeep GN. A study on prescription pattern of antihypertensive agents in chronic renal failure patients and assessment of medication adherence. Int J Pharm Sci Rev Res 2017;45(2):72-5.

Lee S, Oh HJ, Lee EK, Lee O, Ha E, Kim SJ, et al. Blood Pressure Control During Chronic Kidney Disease Progression. Am J Hypertens. 2017;30(6):610-16.

Bhanu PB, Basavanna PL. Pattern of antihypertensive drug utilisation among chronic kidney disease patients in a dialysis unit of a tertiary care hospital. Int J Biomed Res. 2015;6(04):251-4.

Saju AP, Edakkarayil AC, Maheswari E, Gurudev KC. Prescribing pattern and cost effectiveness analysis of antihypertensive drugs in chronic kidney disease patients. Europ J Pharmaceut Med Res. 2016;3(1):219-25.