Assessment of Anti Hypertensive Drugs In Ckd Patients

Abstract

Hypertension is common in hemodialysis patients and can often be difficult to control. Considering the high cardiovascular burden in hemodialysis patients, control of blood pressure is important to improve outcomes. This study is conducted to assess the anti hypertensive drugs treatment in chronic kidney disease (CKD) patients. This is a prospective observational study and includes information regarding CKD patients with co-morbidities like T2DM and HTN and it is conducted among 15 patients which were of both males and females of above 20 yrs of age upto 80 yrs. For these 15 patients e GFR is calculated and stage of severity of CKD was found. Patients with T2DM and Hypertensive are mostly diagnosed with CKD. Loop diuretic (Furosemide)+ calcium channel blocker (Amlodipine) this combination is prescribed more which is found to be safe for CKD patients as for this combination dosage adjustment is not required. In our study among 15 CKD patients 7 dialysis patients were included, majority of the patients have controlled SBP with the anti- hypertensive combinations. acute myocardial infarction 1-3 . They remain the firstline therapy for patients with cardiovascular (CV) disease. Similarly, in patients with diabetic and non-diabetic kidney disease, several large trials have demonstrated their effectiveness in reducing proteinuria and delaying progression of chronic kidney disease. The major adverse effects associated with ACEI and ARB use are hyperkalemia, decrease in glomerular filtration rate (GFR), and erythropoietin resistance. The risk of hyperkalemia increases with the degree of decrease in GFR in the nondialysis population 4 . The most common pattern of BP in dialysis patients is systolic hypertension associated with a wide pulse pressure due to atherosclerotic arterial stiffness. The main pathogenic mechanisms of hypertension in dialysis patients. Extracellular fluid overload is the most common feature in hypertensive dialysis patients. Indeed, insufficient volume removal is often the major factor responsible for dialysis-refractory hypertension 5-9