Assessment of Proportion of Resistant Hypertension and Quality of Life Among Patients with Chronic Kidney Disease: A Prospective Study in A Tertiary Care Centre Kerala

Author(s): Alinta S.B Muth, Anisha D.S, Arya Rajan, Christy Surendran and Neethu J*

Abstract: Aim and Objectives: Aim is to assess the proportion of resistant hypertension by analyzing the prescribing pattern of antihypertensive and quality of life in patients with chronic kidney disease. Methods: This is a prospective observational study with a minimum sample size of 100. Data was collected from those who met the inclusion criteria after obtaining a written informed consent. BP readings and list of antihypertensive prescribed was recorded and the patients were assessed for their blood pressure control. A proper counseling on diet and lifestyle modification was given to each patients and they were assessed for quality of life with KDQOL questionnaire. The statistical analysis was done with SPSS software program and Chi- square tests showed the level of significance with a P value of <0.05. Results-Out of 93 CKD patients selected, 40 (43%) patients were having poly therapy, means that majority of the patients required multiple drug therapy to control their blood pressure at the targeted level. The percentage distribution of drugs was showed that Diuretics were the most prescribed class of drugs comprises 86%. The least prescribed one was ARBS and none of the ACE inhibitors were prescribed. 73.1% of the total population was identified as having resistant hypertension, among which 52 patients with uncontrolled blood pressure. The 10 domain analysis showed that the quality of life among CKD patients improved. General health was one among the significantly affected domains of the KDQOL and increased to an average score of 62.5±14.59% (p=0.0015). An average score of 43.87±24.03% was observed for emotional wellbeing and was found to be better than the General Health and it was statistically significant (p<0.018). Issues related to kidney disease had an average score of 74.02±8.35, which indicates the better QOL after counseling. Conclusion: As resistant hypertension is a phenomenon which remains easily undiagnosed due to under presentation and because the symptoms are not very specific, it is important to consider this disorder in patients with CKD. For patients with CKD, health education focusing on disease and need for long term treatment, also the diet and life style changes provided by the clinical pharmacist plays an important role in improving the ability to cope up with illness and health status. Pharmacists are in an ideal position to provide patient education and optimize patient care. Greater understanding about the illness and a change of diet and lifestyle would in turn results in a better therapeutic outcome.

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