Objective:
Hypertension (HTN) is both a cause and an effect of chronic kidney disease (CKD). To adequately control blood pressure (BP) i
n CKD,
choosing antihypertensive strategies with the highest nephro
-protective effect is crucial for preventing or rever
sing end
-stage renal disease (ESRD)
progression and reducing cardiovascular disease (CVD) risk. The present study was therefore designed to evaluate the impact o
f clinical use of
antihypertensive drug therapy in patients with CKD and ESRD.
Method
s:
It is a prospective observational cohort study. The patients were divided into two cohorts i.e.; non-
dialysis dependent (NDD) and dialysis
-
dependent (DD) CKD. This study was conducted for six months in the Nephrology
department,
Osmania General Hospital
, H
yderabad, India. The
data collected and entered into Microsoft Excel (2007) and mean, SD and range were cal
culated using SPSS version 25.
Result
s:
Antihypertensive drugs were prescribed alone or in combination based on the co
-morbidities associated with CKD and HTN. Loop diuretics
(Furosemide and Torsemide) and calcium channel blocker (Amlodipine, Nifedipine and Cilnidipine) were most commonly prescribed
antihypertensive drugs. Triple therapy (44.11%) was prescribed mostly in both the cohorts (NDD = 16.66
%
+DD = 27.45%) of which calcium
channel blockers
+loop diuretic
+sympatholytic accounts for 19.16% (NDD = 5.88%
+DD = 13.73%).
Conclusio
n:
The practice of prescribing antihypertensive drugs for the management of HTN and to
achieve BP targets in CKD and ESRD remains
uncertain.
The development of new and revised guidelines is needed to reduce inappropriate variations in practice and promote better del
ivery of
evidence
-based treatment.