Antihypertensive Drug Utilisation Pattern Among Chronic Kidney Disease Patients Undergoing Maintenance Dialysis in a Tertiary Care Teaching Hospital

BACKGROUNDThe world is facing a global epidemic of Chronic Kidney Disease (CKD), a major threat to health in general because of an increasing incidence, high cost of treatment and poor outcome associated with various adverse events and comorbidities.Although improved control of hypertension is known to attenuate progression of Chronic Kidney Disease (CKD), a little is known about the adequacy of treatment of hypertension in patients with CKD in India. AIMTo analyse the utilisation pattern of anti-hypertensive agents in patients with Chronic Kidney Disease in a tertiary care teaching Hospital. MATERIAL AND METHODSA descriptive prospective study was conducted in the Department of Nephrology, S. C. B. Medical College and Hospital, Cuttack, for a period of 6 months from 1 st January 2015 to 30th June 2015.Relevant patient information, data regarding Anti-Hypertensive Drugs Utilization pattern entered in a preformed proforma in Microsoft Excel sheet for compilation and subjected to statistical analysis. RESULTSTotal 100 case records were analysed.Mean age was 55.37±13.41years.Male-female ratio was 2.7.Maximum number of patients were from age group 51-60 years (43%) followed by age group 41-50 years (29%).All the patients (100%) were hypertensives, among which 42% patients of the study population were diabetic with hypertension and rest of the patients (58%) were non-diabetic with hypertension.Routinely prescribed anti-hypertensives are CCB, β blockers, diuretics, α blockers, ACEI and centrally acting sympatholytics.Among them, Calcium Channel Blockers (32.47%) were most frequently used followed by β Blockers (24.78%),Diuretics (23.50%),Centrally Acting Sympatholytics (10.25%), α Blockers (7.69%) and ACE Inhibitors (1.28%).Hypertension in CKD patients was very difficult to manage.Approximately, two-third of the patients (66%) had BP >140/90 mmHg with anti-hypertensive therapy.Targeted blood pressure control was present in (34%) of the patients. CONCLUSIONControl of hypertension is poor in participants with CKD and that lack of control is primarily Systolic Hypertension.So a permutation and combination of various anti-hypertensive agents were used in CKD patients undergoing maintenance dialysis.