Blood Pressure Control and Its Determinants among Patients with Non-Dialysis Chronic Kidney Disease in Myanmar

Abstract

Background: Controlling blood pressure is critical for patients with non-dialysis chronic kidney disease to prevent the rapid progression to end-stage renal disease and sudden cardiac death. However, only a limited number of these patients achieve the blood pressure target. No previous study has been observed to evaluate the status of blood pressure control and its determinants among Myanmar patients with non-dialysis chronic kidney disease.Purpose: This study aimed to identify the rate of blood pressure control and its determinants among patients with non-dialysis chronic kidney disease in Myanmar.Methods: A total of 150 patients with non-dialysis chronic kidney disease attending the clinics at a tertiary hospital in Myanmar participated in this cross-sectional, correlational predictive study. They were recruited by a convenience sampling method. Data were collected by using Sodium Consumption Behavior Questionnaire, Family-Friends Support Subscale and Doctor-Health Care Team Support Subscale of Chronic Illness Resources Survey, demographic and clinical characteristics data form, and by measuring blood pressure against the target level of less than 130/80 mmHg. Descriptive statistics, Chi-square, Fisher’s exact test, and binary logistic regression analysis were performed.Results: Only 44% of the participants had their blood pressure controlled. Overweight (OR=0.170, 95% CI: 0.058-0.495), obese (OR=0.071, 95% CI: 0.017-0.305), and chronic kidney disease stage 5 (OR=0.070, 95% CI: 0.020-0.244) were the determinants associated with poorly controlled blood pressure. Low sodium consumption behavior (OR=9.065, 95% CI: 3.251-25.277) and high family support (OR=7.799, 95% CI: 2.738-22.215) were the determinants associated with well-controlled blood pressure.Conclusion: The blood pressure control rate in Myanmar patients with non-dialysis chronic kidney disease was suboptimal. Determinant findings serve as an input to endorse family-based lifestyle modification interventions such as weight control and low sodium dietary for optimizing blood pressure control. Further investigation of other determinants and of lifestyle intervention programs is warranted.

Socio-Demographic and Clinical Profiles Associated with Sodium Consumption Behaviors in Patients with Non-Dialysis Chronic Kidney Disease: A Study in Myanmar

“…The primary study was conducted at out-patient clinics in a tertiary hospital in Myanmar from February to May 2020. Data from a hospital-based study to explore blood pressure control in 150 non-dialysis CKD patients by Mon et al (2022) were used due to data collection challenges during COVID-19 pandemic and political situation in Myanmar. Participants were recruited if they had eGFR less than 60 ml/min/1.73m 2 , had never been treated with dialysis, could communicate in Burmese, had no severe physical and mental illnesses, had no cognitive impairment, and had no changes in antihypertensive medications during the past three months.…”

“…Data from the original study were collected by the principal investigator at the outpatient clinics at a tertiary hospital, Myanmar. Details of data collection procedures and measurement were published in the study of Mon et al (2022). In this study, the independent variables included socio-demographic (age, gender, educational level, income, and follow-up visit) and clinical (CKD severity, comorbidity, and taking antihypertensive medication) characteristics.…”

“…In this study, the CKD severity (eGFR) was classified based on the CKD stage (eGFR) as follows: stage 3 CKD with eGFR of 30-59 ml/min/1.73m 2 ; stage 4 CKD with eGFR of 15-29 ml/min/1.73m 2 ; and stage 5 CKD with eGFR of <15 ml/ min/1.73m 2 (KDIGO Work Group, 2013). These data and other characteristics (e.g., marital status, occupation, smoking, alcohol drinking, and cooking meal) were obtained from the demographic and clinical characteristics data form designed by Mon et al (2022). The participants responded to the part of socio-demographic form during their waiting time at the clinic.…”

“…The dependent variable in this study was SCB obtained from Sodium Consumption Behavior Questionnaire (SCBQ) developed by Piaseu et al (2020). The SCBQ was translated into Burmese language by using the back-translation method (Mon et al, 2022). The questionnaire is valid and reliable.…”

“…Although studies in different countries have highlighted the significance of SCB, knowledge regarding SCB in people with non-dialysis CKD in Myanmar is limited. Only one such study was conducted in Myanmar by Mon et al (2022) who found that patients with CKD who have not been receiving dialysis treatment (non-dialysis CKD patients) had low to moderate consumption of salt intake, and those who had good SCB had better blood pressure control. Moreover, among Myanmarese with non-dialysis CKD, little is known about factors associated with their SCB.…”