Key result
Amlodipine combined with a beta-adrenoceptor blocker provided the best blood pressure control across all dialysis phases with minimal intradialytic complications in hemodialysis patients.
Why the study?
Which antihypertensive drug regimen provides the best blood pressure control and least intradialytic complications in patients with end-stage renal disease on hemodialysis?
Observational (n=112)
No
Which antihypertensive drug regimen provides the best blood pressure control and least intradialytic complications in patients with end-stage renal disease on hemodialysis?
In hemodialysis patients, a combination of amlodipine and a beta-blocker provided optimal blood pressure control with fewer intradialytic complications compared to clonidine-based regimens.
Background: Cardiovascular complications are the leading cause of morbidity and mortality in the patients of end-stage renal disease leading to hemodialysis. Majority of these patients suffers from hypertension and adequate control of blood pressure is a challenge in these patients because of multifactorial etiology and complicated pharmacokinetic changes in these patients. The present study aims is to find out the best possible drug or combination of drugs that can provide better control of blood pressure and improve the quality of life of these patients.Methods: A retrospective study was carried out on the patients who attended the hemodialysis unit of Hakeem Abdul Hamid Centenary hospital from July 2015 to June 2016 (one year), data on antihypertensive drugs and blood pressure control (pre-dialysis and post-dialysis) were recorded and analyzed.Results: 68.75% patients on hemodialysis were suffering from hypertension and were on antihypertensive medication. A combination of Amlodipine and clonidine were the most frequently prescribed antihypertensive agents. Muscle cramps an acute rise in blood pressure and hypotension were the most frequently encountered intradialytic complications in these patients.Conclusions: Although a combination of amlodipine and clonidine was most frequently prescribed antihypertensive medication in these patients these drugs were associated with intradialytic complications like muscle cramps and hypotension. Amlodipine with beta-adrenoceptor blocker (metoprolol or bisoprolol) provided best control of blood pressure in these patients with least intradialytic complications.
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Ahmad et al. (2017) conducted an observational in End-stage renal disease on hemodialysis with hypertension (n=112). Amlodipine combined with beta-adrenoceptor blocker vs. Other antihypertensive regimens (e.g., amlodipine + clonidine) was evaluated on Blood pressure control (inter-dialysis, pre-dialysis, and post-dialysis) and intradialytic complications. Amlodipine combined with a beta-adrenoceptor blocker provided the best blood pressure control across all dialysis phases with minimal intradialytic complications in hemodialysis patients.
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