Abstract

PHARMACOLOGICAL MANAGEMENT OF HYPERTENSION IN CKD PATIENTS UNDERGOING HEMODIALYSIS

Sabreena P.*, Anagha K. and Sajith P.

ABSTRACT

Hypertension is the second most leading independent cause of end-stage renal disease (ESRD) after diabetes, the risk of which increases continuously with the extent and duration of elevated blood pressure (BP). The purpose of the study is to identify the most suitable pharmacological management of hypertension in patient with chronic kidney disease (CKD) undergoing haemodialysis and to select safest and most effective anti-hypertensive drug combinations in CKD patients. The present study was carried out in (CKD) patients on dialysis undergoing antihypertensive treatment. Inpatients of nephrology department were included in the study. Pregnant women and subjects below 18 years were excluded from the study. The patients who were enrolled in the study and their care takers were interviewed and data was recorded in the data collection form. A total of 110 patients who were using at least one antihypertensive drug participated in the study and the maximum incidence of hypertension was found in the age group of 50-70. Number of patients in each hypertension stages lowered after drug-therapy Most of the patients were under antihypertensive monotherapy. Classes of antihypertensive drugs prescribed were CCBs, β-blockers, diuretics, ARBs and ACE inhibitors. CCBs and β blockers are the most prescribed drugs in monotherapy. Furosemide is used primarily for reducing extra cellular volume in CKD patients. CCBs and beta blockers are the most used antihypertensive drug class, amlodipine and the metoprolol is the most effective and safe drug in CKD patients with hypertension. Carvedilol combined with furosemide and amlodipine with furosemide are the effective combination.

Keywords: CKD; Haemodialysis; Hypertension; Anti-hypertensives; CCBs.