Blood Pressure Control During Chronic Kidney Disease Progression

Lee, Seulbi; Oh, Hyung Jung; Lee, Eun Kyung; Lee, Oesook; Ha, Eun–Hee; Kim, Seung Jung; Kang, Duk Hee; Choi, Kyu Bok; Ryu, Dong Ryeol

doi:10.1093/ajh/hpx017

Cited by 19 publications

(24 citation statements)

References 22 publications

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“…One-third of the patients were diagnosed with CKD stage 5. It is more difficult for patients in the late stage of CKD to control their BP [16,17]. Moreover, many of these cases had diabetes and CVD as comorbidities.…”

Section: Discussionmentioning

confidence: 99%

“…In particular, physiological factors, such as age, stage of CKD, diabetes mellitus and cardiovascular diseases (CVDs) have been found to be inconsistent in prior studies. Older age [16], a higher stage of CKD [17], having diabetes [9] and CVD [17] have been identified as factors that are associated with uncontrolled BP. On the other hand, some studies found no association between these factors with uncontrolled BP [6,18].…”

Section: Introductionmentioning

confidence: 99%

“…Likewise, studies of gender as a genetic determinant had mixed results. One study found uncontrolled BP in males [17], while another study found uncontrolled BP in females [16], and some studies found that gender did not affect BP levels [9,18]. In addition, some studies identified a patient's background characteristics such as marital status [19], education level [20] and employment [21] as associated factors of uncontrolled BP.…”

Section: Introductionmentioning

confidence: 99%

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Rate of uncontrolled blood pressure and its associated factors in patients with predialysis chronic kidney disease in Bali, Indonesia

Dharmapatni

Sriyuktasuth

Pongthavornkamol

2020

JHR

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PurposeHypertension is a key determinant for the development and progression of chronic kidney disease (CKD). The purpose of this study is to assess the rate of uncontrolled blood pressure (BP) and identify its associated factors in patients with predialysis CKD in Bali, Indonesia.Design/methodology/approachA cross-sectional study was conducted among 165 patients who attended the nephrology clinic in a central public hospital in Bali. Data were obtained by measuring BP at threshold 130/80 mmHg, as well as collected through standardized questionnaires. Univariate analysis was done using Chi-square test, and multivariate analyses were carried out using multiple logistic regression.FindingsA total of 165 patients (111 males and 54 females) with predialysis CKD participated in this study. About 64% of the participants had uncontrolled BP. In multiple logistic regression, all selected variables significantly explained 63.2% of the variance in uncontrolled BP. However, low physical activity (odds ratio [OR] = 24.287, 95% confidence interval [CI]: 3.114–189.445), unhealthy dietary pattern (OR = 10.153, 95% CI: 2.770–37.210), as well as perceived moderate stress (OR = 4.365, 95% CI: 1.024-18.609) and high stress (OR = 10.978, 95% CI: 2.602–46.312) were significantly associated with uncontrolled BP.Research limitations/implicationsThe study findings provide evidence for health care providers to improve BP control among patients with predialysis CKD.Originality/valueControlling BP among patients with predialysis CKD was poor. Lifestyle modification and stress management are keys to improving BP control.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Rate of uncontrolled blood pressure and its associated factors in patients with predialysis chronic kidney disease in Bali, Indonesia

Dharmapatni

Sriyuktasuth

Pongthavornkamol

2020

JHR

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“…Established risk factors such as hypertension probably explain much of the increased cardiovascular risk in CKD. Although hypertension is associated with renal dysfunction (Rao et al, 2008), more rapid progression of CKD and the development of various cardiovascular comorbidities (Go et al, 2004;Botdorf et al, 2011;Segura & Ruilope, 2011), it is common that blood pressure (BP) is inadequately controlled in CKD patients (Peralta et al, 2005;Lee et al, 2017). Non-traditional risk factors, such as inflammation and disruptions in mineral metabolism, have also been shown to play a role in the increased cardiovascular risks in CKD (Chue et al, 2010;Chue et al, 2012;Major et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular changes in patients with mild‐to‐moderate chronic kidney disease compared with healthy subjects: a 5‐year follow‐up study

Anna¹,

Wallquist²,

Rickenlund³

et al. 2019

Clin Physio Funct Imaging

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Background There is limited knowledge about how cardiovascular parameters change over time in patients with mild-to-moderate chronic kidney disease (CKD). We studied several cardiovascular biomarkers over a 5-year period in patients with mild-to-moderate CKD and in healthy controls. Methods Fifty-four patients with CKD stages 2-3 and 54 controls were included. The CKD patients were closely monitored and well controlled for hypertension and other cardiovascular risk factors. Ambulatory blood pressure (BP) monitoring, ankle-brachial index (ABI), carotid and cardiac ultrasound (including measurement of the left ventricular mass index (LVMI)), and biochemical analyses were evaluated. Results Renal function decreased in both groups, with no significant difference in the change over time. In the CKD patients, none of the BP variables increased over time, but in the controls, average 24-h and daytime systolic BP increased significantly. ABI increased slightly in the CKD patients (P<0Á001), but not in the controls (P = 0Á963), and phosphate had a significant positive effect on ABI. Although in the CKD patients, there was no significant increase over time in common carotid artery diameter (P = 0Á274), there was a small but significant increase in the controls (P = 0Á001). LVMI increased significantly over time in both groups. Conclusions In our study of patients with mild-to-moderate CKD, the progression of cardiovascular changes over time was relatively slow. Good BP control and treatment of other risk factors may have contributed to slow the progress of cardiovascular involvement, which emphasizes the importance of dedicated care in this population.

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“…Several studies have reported poor BP control in CKD with an apparent 2-fold variability across countries. The prevalence of uncontrolled hypertension above 140/90 mm Hg in individuals with CKD ranges from near 35% in South Korea 17 and the United States 18,19 to more than 70% in Turkey; 20 that of BP above 130/80 mm Hg varies from 55% to 65% in the United States, 18,19 65% in the UK, 21 75% in Germany, 22 80% in Japan, 23 and close to 90% in China. 24,25 Some sources of these variations among different populations may include CKD severity, prevalence of risk factors, and patterns of antihypertensive treatment.…”

mentioning

confidence: 99%

Considerable international variation exists in blood pressure control and antihypertensive prescription patterns in chronic kidney disease

Pinho¹,

Levin²,

Fukagawa³

et al. 2019

Kidney International

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A rterial hypertension is prevalent in chronic kidney disease (CKD) and contributes to its adverse outcomes. 1 The major benefits of lowering blood pressure (BP) for survival and cardiovascular outcomes are well established, as are those of inhibiting the renin angiotensinaldosterone system (RAAS) to slow CKD progression. 2-8 BP control and RAAS inhibitor use are therefore major goals in the management of patients with CKD, 9 although no consensus exists about the ideal BP level. Current guidelines

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Blood Pressure Control During Chronic Kidney Disease Progression

Cited by 19 publications

References 22 publications

Rate of uncontrolled blood pressure and its associated factors in patients with predialysis chronic kidney disease in Bali, Indonesia

Rate of uncontrolled blood pressure and its associated factors in patients with predialysis chronic kidney disease in Bali, Indonesia

Cardiovascular changes in patients with mild‐to‐moderate chronic kidney disease compared with healthy subjects: a 5‐year follow‐up study

Considerable international variation exists in blood pressure control and antihypertensive prescription patterns in chronic kidney disease

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