Key result
Using ≥3 antihypertensive medications is linked to an absolute ~17% higher rate of uncontrolled predialysis BP.
Why the study?
Hypertension in end-stage CKD patients undergoing hemodialysis is difficult to control, and the relationship between antihypertensive use and uncontrolled blood pressure is unclear.
Does the use of ≥3 antihypertensive medications or dialyzable antihypertensive drugs improve predialysis blood pressure control in adults with end-stage chronic kidney disease on routine hemodialysis?
Cohort (n=52)
No
Does the use of ≥3 antihypertensive medications or dialyzable antihypertensive drugs improve predialysis blood pressure control in adults with end-stage chronic kidney disease on routine hemodialysis?
Absolute Event Rate: 100% vs 82.6%
p-value: p=0.033
In patients with chronic kidney disease undergoing hemodialysis, the requirement of three or more antihypertensive medications is significantly associated with uncontrolled predialysis blood pressure, reflecting the difficulty of managing hypertension in this population.
≥3 antihypertensives associated with uncontrolled predialysis BP in HD patients; leaves open whether polypharmacy reflects resistant hypertension or drives poor control.
Hypertension in end-stage chronic kidney disease (CKD) patients undergoing HD is difficult to control. The aim of the study was to determine the relationship between the number of antihypertensive medications taken and the use of dialyzed antihypertensive medications on uncontrolled blood pressure in CKD patients on hemodialysis. Consecutive sampling was employed in a retrospective cohort study. Data collection for the study took place in July 2023 at Temanggung Regional Hospital. The inclusion criteria in this study were CKD patients who undergoing routine hemodialysis twice a week, aged ≥ 18 years, and without or with comorbidities. Medical records and interviews with research participants were used to gather data. Forty-eight patients with clinical outcomes of uncontrolled predialysis blood pressure and four patients with regulated predialysis blood pressure made up the 52 research subjects. The number of antihypertensive drugs used is significantly associated with uncontrolled predialysis blood pressure in CKD patients with hemodialysis using antihypertensives (p-value 0,033). The use of dialyzed antihypertensive drugs is not associated with uncontrolled predialysis blood pressure in CKD patients on hemodialysis using antihypertensives (p-value 0,115).
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Pulungan et al. (2025) conducted a cohort in Chronic Kidney Disease undergoing routine hemodialysis (n=52). Use of ≥3 antihypertensive medications vs. Use of <3 antihypertensive medications was evaluated on Uncontrolled predialysis blood pressure (p=0.033). The use of three or more antihypertensive medications was significantly associated with a higher rate of uncontrolled predialysis blood pressure (100% vs 82.6%) in chronic kidney disease patients on hemodialysis.
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