Factors associated with blood pressure in end stage renal disease patients receiving regular hemodialysis at Wangaya general hospital, Denpasar

Abstract

Background: Hypertension is common findings in end-stage renal disease (ESRD) patients receiving hemodialysis, around two third among them are poorly controlled. We analyzed factors affecting blood pressure in patients undergoing regular hemodialysis.Methods:A single center cross-sectional study conducted including 65 patients receiving regular hemodialysis at hemodialysis unit Wangaya general hospital, Bali, Indonesia. Ordinal regression test was performed to analyze the relationship between factor associated with blood pressure in regular hemodialysis patients.Results: Among subjects included, 64 (98.5%) subject had hypertension and 22 (34.4%) subjects had well controlled blood pressure (<140/90 mmHg), 20 (31.3%) subjects had blood pressure between 140/90 to 160/100 mmHg and 22 (34.4%) subjects had blood pressure >160/100 mmHg. Univariate analysis showed statistically significant associated factors were higher number of antihypertensive medications (p=0.002), higher level of hemoglobin (p=0.008), hematocrit (p=0.012) and urea (p=0.041). Multivariate analysis showed higher amount of anti-hypertensive medications and year of dialysis were statistically significant associated with blood pressure in regular hemodialysis patients.Conclusions:Significant factors associated with blood pressure in regular hemodialysis patients were higher amount of anti-hypertensive medications and increased year of dialysis.

Prevalence and factors associated with uncontrolled blood pressure in dialysis patients using antihypertensive: a narrative review

“…A cross sectional study and an observational retrospective concluded that gender was not related to uncontrolled blood pressure in regular hemodialysis patients (p = 0.878 and p = 0.83). 6,14 There was also no significant difference between the controlled and uncontrolled blood pressure groups in hemodialysis patients. 9 However, the findings of these studies did not concur with the cross-sectional study of Amr et al 7 which concluded that gender was significantly associated with blood pressure (p = 0.002).…”

“…A total of 175 articles were identified through database searches, comprising 27 from PubMed, 30 from Scopus and 118 from Google Scholar. Furthermore, a total of 160 articles were excluded for various reasons, including duplicates (6), irrelevant (24), non-dialysis (58), not original research (24), case reports (44), and post-renal transplantation (4). Therefore, the full-text articles assessed for eligibility was 15 (FIGURE 1).…”

“…Nugraha et al 6 study in Indonesia demonstrated that age did not exhibit any correlation with blood pressure levels among routine hemodialysis patients. Similar findings were observed in a study conducted in Palestine, where patients were categorized into three distinct age groups of 18-40, 41-60, and >60 y.o.…”

“…The highest prevalence of uncontrolled blood pressure in hemodialysis patients was found in Indonesia, ranging from 65.6 -78.33%. 6,12 The second highest prevalence was in Brazil with 72%, followed by 64% in Saudi Arabia, 59% in studies in South of Palestine, 58% in studies in Europe, 46% in studies in 3 countries (Italy, Greece and Slovenia), and 28.7% in studies in Pakistan. [7][8][9][10][11]14 Not only in hemodialysis patients, but also the prevalence of uncontrolled blood pressure in peritoneal dialysis patients is quite high, namely 42.2%.…”

“…A study showed that number of antihypertensive was correlated with uncontrolled blood pressure. 6 Most patients received 2 antihypertensives (46.2%). However, this result was inconsistent with another study.…”