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

Abstract

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.

Risk factors associated with uncontrolled blood pressure among patients with non-dialysis chronic kidney disease in Vietnam

“…The study found that 63.2% of the participants were incapable of controlling their BP less than 130/80 mmHg. This finding was consistent with previous studies that demonstrated the uncontrolled BP rates among NDCKD patients were in the range of 63.7%-64.8% (Zhang et al, 2019;Dharmapatni et al, 2020).…”

“…However, no study was conducted among patients with NDCKD. In terms of genetic factors, mixed results were demonstrated regarding the association between gender and uncontrolled BP in prior studies conducted in different settings (Lee et al, 2017 ; Dharmapatni et al, 2020 ). It can be seen that inconsistent findings were found between alcohol consumption, smoking status, age, DM, gender, and uncontrolled BP in previous studies.…”

“…In parallel with the high prevalence of CKD, blood pressure (BP) often elevates in patients with CKD, occupying 60%-90% (Ku et al, 2019 ). Moreover, previous studies illustrated the high rate of patients with Non-Dialysis CKD (NDCKD) who could not control their BP less than 130/80 mmHg as recommended (Whelton et al, 2018 ), ranging from 64%-88% (Zheng et al, 2013 ; Unni et al, 2015 ; Dharmapatni et al, 2020 ). Poor BP control increased 1.84-1.93 times of renal progression in patients in the early stages of CKD, leading to end-stage renal disease (ESRD) and the development of cardiovascular diseases (CVDs) (KDIGO, 2012 ; Chang et al, 2016 ).…”

“…Regarding physiology factors, previous studies found inconsistent findings between age, diabetes mellitus (DM), and uncontrolled BP. Some studies have proved a significant association between age, DM, and uncontrolled BP (Lee et al, 2017 ; Yan et al, 2018 ), but another study proposed an opposite finding (Dharmapatni et al, 2020 ). For comorbidity, it has been widely known that CKD mostly accompanied with comorbidity.…”

Blood pressure control and its associated factors in patients with hypertension and type 2 diabetes

“…More than one third of the hypertensive patients enrolled in several other studies had poorly controlled hypertension [30][31][32]. Other studies conducted among hypertensive patients with chronic kidney disease found that more than 60% of the patients had uncontrolled BP [33,34]. These findings highlight the value of investigating the primary contributing variables of poor BP control in hypertensive patients with diabetes in order to create effective strategies for controlling BP and overcoming the challenges in obtaining such a target among these patients.…”