open access
Blood pressure control among patients with chronic kidney disease in Saudi Arabia: a single-center experience
Affiliations- Department of Internal Medicine, College of Medicine, King Faisal University, Al-Hasa, Saudi Arabia
open access
Abstract
Background: Chronic kidney disease (CKD) is a global health challenge that contribute to substantial patients’ morbidity and mortality. Hypertension is highly prevalent among CKD patients, resulting in higher risks of cardiovascular events and CKD progression. We aim to explore the state of blood pressure (BP) control among pre-dialysis CKD patients, and to explore the factors contributing to its poor control in this group of patients.
Material and methods: This is an observational retrospective study examining the prevalence of hypertension and factors associated with BP control in patients with pre-dialysis CKD at a large tertiary hospital in Saudi Arabia. Data were analyzed using SAS Version 9.2 by SAS Institute Inc., Cary NC, United States.
Results: A total of 339 patients with pre-dialysis CKD were included in this study. The mean age of the study population was 53.5 ± 16.6, and 55% were male. The prevalence of hypertension was as high as 89%, with 216 (64%) patients being identified as having uncontrolled BP. Age groups 18–39 years, or more than 60 years were significantly associated with poor BP control (p < 0.001). Additionally, diabetes (p < 0.001), obesity (p < 0.003), and advance CKD stage were significantly associated with poor BP control.
Conclusion: BP control is suboptimal among pre-dialysis CKD patients in Saudi Arabia, putting this population at higher risk of CKD progression and cardiovascular events. Large scale efforts and interventions in Saudi Arabia are needed to tackle this problem through multidisciplinary approaches in order to improve the outcomes of CKD patients with hypertension.
Abstract
Background: Chronic kidney disease (CKD) is a global health challenge that contribute to substantial patients’ morbidity and mortality. Hypertension is highly prevalent among CKD patients, resulting in higher risks of cardiovascular events and CKD progression. We aim to explore the state of blood pressure (BP) control among pre-dialysis CKD patients, and to explore the factors contributing to its poor control in this group of patients.
Material and methods: This is an observational retrospective study examining the prevalence of hypertension and factors associated with BP control in patients with pre-dialysis CKD at a large tertiary hospital in Saudi Arabia. Data were analyzed using SAS Version 9.2 by SAS Institute Inc., Cary NC, United States.
Results: A total of 339 patients with pre-dialysis CKD were included in this study. The mean age of the study population was 53.5 ± 16.6, and 55% were male. The prevalence of hypertension was as high as 89%, with 216 (64%) patients being identified as having uncontrolled BP. Age groups 18–39 years, or more than 60 years were significantly associated with poor BP control (p < 0.001). Additionally, diabetes (p < 0.001), obesity (p < 0.003), and advance CKD stage were significantly associated with poor BP control.
Conclusion: BP control is suboptimal among pre-dialysis CKD patients in Saudi Arabia, putting this population at higher risk of CKD progression and cardiovascular events. Large scale efforts and interventions in Saudi Arabia are needed to tackle this problem through multidisciplinary approaches in order to improve the outcomes of CKD patients with hypertension.
Keywords
chronic kidney disease; hypertension; uncontrolled blood pressure; Saudi Arabia
About this articleTitle
Blood pressure control among patients with chronic kidney disease in Saudi Arabia: a single-center experience
Journal
Issue
Article type
Original paper
Pages
73-77
Published online
2023-03-10
Page views
1488
Article views/downloads
399
DOI
Bibliographic record
Arterial Hypertension 2023;27(2):73-77.
Keywords
chronic kidney disease
hypertension
uncontrolled blood pressure
Saudi Arabia
Authors
Muthana Al Sahlawi
References (20)- Tonelli M, Wiebe N, Culleton B, et al. Chronic kidney disease and mortality risk: a systematic review. J Am Soc Nephrol. 2006; 17(7): 2034–2047.
- Anderson S, Halter JB, Hazzard WR, et al. workshop participants. Prediction, progression, and outcomes of chronic kidney disease in older adults. J Am Soc Nephrol. 2009; 20(6): 1199–1209.
- Jha V, Wang AYM, Wang H. The impact of CKD identification in large countries: the burden of illness. Nephrol Dial Transplant. 2012; 27 Suppl 3: iii32–iii38.
- Kefale B, Alebachew M, Tadesse Y, et al. Quality of life and its predictors among patients with chronic kidney disease: A hospital-based cross sectional study. PLoS One. 2019; 14(2): e0212184.
- GBD Chronic Kidney Disease Collaboration. Global, regional, and national burden of chronic kidney disease, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2020; 395(10225): 709–733.
- Farag YMK, Kari JA, Singh AK. Chronic kidney disease in the Arab world: a call for action. Nephron Clin Pract. 2012; 121(3-4): c120–c123.
- Robert AA, Al Dawish MA. The Worrying Trend of Diabetes Mellitus in Saudi Arabia: An Urgent Call to Action. Curr Diabetes Rev. 2020; 16(3): 204–210.
- AlSahow A, AlRukhaimi M, Al Wakeel J, et al. GCC-DOPPS 5 Study Group. Demographics and key clinical characteristics of hemodialysis patients from the Gulf Cooperation Council countries enrolled in the dialysis outcomes and practice patterns study phase 5 (2012-2015). Saudi J Kidney Dis Transpl. 2016; 27(6 Suppl 1): S12–S23.
- Kalaitzidis R, Li S, Wang C, et al. Hypertension in early-stage kidney disease: an update from the Kidney Early Evaluation Program (KEEP). Am J Kidney Dis. 2009; 53(4 Suppl 4): S22–S31.
- Coresh J, Wei GL, McQuillan G, et al. Prevalence of high blood pressure and elevated serum creatinine level in the United States: findings from the third National Health and Nutrition Examination Survey (1988-1994). Arch Intern Med. 2001; 161(9): 1207–1216.
- Sarafidis PA, Li S, Chen SC, et al. Hypertension awareness, treatment, and control in chronic kidney disease. Am J Med. 2008; 121(4): 332–340.
- Ettehad D, Emdin C, Kiran A, et al. Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis. Lancet. 2016; 387(10022): 957–967.
- Fraser SDS, Roderick PJ, McIntyre NJ, et al. Suboptimal blood pressure control in chronic kidney disease stage 3: baseline data from a cohort study in primary care. BMC Fam Pract. 2013; 14: 88.
- Lee JY, Han SH. Blood pressure control in patients with chronic kidney disease. Korean J Intern Med. 2021; 36(4): 780–794.
- Cedillo-Couvert EA, Ricardo AC, Chen J, et al. CRIC Study Investigators. Self-reported Medication Adherence and CKD Progression. Kidney Int Rep. 2018; 3(3): 645–651.
- Molnar MZ, Gosmanova EO, Sumida K, et al. Predialysis Cardiovascular Disease Medication Adherence and Mortality After Transition to Dialysis. Am J Kidney Dis. 2016; 68(4): 609–618.
- Mason NA. Polypharmacy and medication-related complications in the chronic kidney disease patient. Curr Opin Nephrol Hypertens. 2011; 20(5): 492–497.
- Liu M, Li XC, Lu L, et al. Cardiovascular disease and its relationship with chronic kidney disease. Eur Rev Med Pharmacol Sci. 2014; 18(19): 2918–26.
- Ryu H, Kim J, Kang E, et al. Representing KNOW‑CKD Study Group, Representing KNOW-CKD Study Group. Risk of major cardiovascular events among incident dialysis patients: A Korean national population-based study. Int J Cardiol. 2015; 198(33): 95–101.
- National Institute for Health . National Institute for Health and Care Excellence: Guidelines. Chronic kidney disease: assessment and management. National Institute for Health and Care Excellence (NICE), London 2021.