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Utilization pattern of antihypertensive drugs among chronic kidney disease patients in a tertiary care hospital

Ritika Singh, Pankaj Hans, Nikhil Era, Shatavisa Mukherjee, Sushanta Kumar Bordoloi.




Abstract

Background: Chronic kidney disease (CKD) exists both as a common cause of hypertension and also a complication of uncontrolled hypertension. This complex interplay of hypertension and CKD further increases the risk of adverse cardiovascular and cerebrovascular outcomes in patients with compromised renal function.

Aim and Objectives: The present study tried analyze the characteristics of hypertensive CKD patients and the current antihypertensive treatment pattern in CKD patients in a tertiary care set up in Eastern India.

Materials and Methods: A prospective and observational study included adult currently diagnosed CKD patients along with hypertension. Basic demographics along with medical history, blood pressure (BP) measures treatment details, and laboratory information were retrieved for each included patient, noted and analyzed statistically.

Results: Around 47% patients were taking two antihypertensives, followed by 19.7% on three and 17.97% on one antihypertensive, respectively, and over 50% patients demonstrating high normal BP, followed by 25% having Grade I hypertension and around 20% having Grade II hypertension. Various classes of antihypertensives prescribed in the present study included calcium channel blockers, beta-blockers, angiotensin receptor blocker, angiotensin-converting enzyme (ACE) inhibitors, centrally acting drugs, alpha-blockers, and diuretics. Beta-blockers were found to be the most prescribed antihypertensives, being prescribed in 92.69% CKD patients. This was followed by calcium channel blockers, centrally acting drugs, alpha-blockers, angiotensin receptor blocker, diuretics, and ACE inhibitor. Utilization pattern of antihypertensive drugs among CKD patients helps with a better glimpse on the status of BP control and related renal outcomes in hypertensive CKD patients.

Conclusion: Considering the interplay of hypertension and CKD, it is imperative to essentially treat hypertension robustly to ensure better cardio and renoprotection in these CKD patients. Utilization pattern of antihypertensive drugs among CKD patients helps with a better glimpse on the status of BP control and related renal outcomes in such patients. A rational multidrug antihypertensive regime can help achieve better patient outcomes in hypertensive CKD patients.

Key words: Antihypertensives; Chronic Kidney Disease; Drug Utilization Pattern






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