Drug Utilization of Anti Hypertensives in CKD Patients: A Randomized Prospective Study at a Tertiary Care Teaching Hospital
AIMS AND OBJECTIVES: Our aim was to evaluate the clinical use of Antihypertensive drugs in patients with chronic Kidney disease at a tertiary care teaching hospital.
METHOD: An observational, prospective cohort study was conducted at a tertiary care teaching hospital in Hyderabad, T.S, India. A total of 184 patients from the inpatient department of nephrology Department at Gleneagles Global Hospitals, Bairamalguda, LB Nagar, Hyderabad. All information significant to the study was collected from the case records and discussions conducted with the in-patients and bystanders during ward rounds, with the support of a physician, which were analyzed by SPSS software. Moreover, daily follow-ups were conducted to assemble data on amendment in therapy, add-on therapy, and clinical improvement.
RESULTS: The Mean Age was 59.29 years and the standard deviation was 1.116 of the population, 60% were smokers and 40% were alcoholics. The most commonly used Class of anti-hypertensive drugs are Calcium channel blockers with percentage of 64.13%, Diuretics with percentage of 57.60%, β blockers with percentage of 43.47%. Whereas most commonly used Calcium channel blockers are Amlodipine with percentage of 52%, and Cilindipine with percentage of 9.10%.Diuretics are are Furosemide with percentage of 36.90% and Toresemide 11.40%. Most commonly used Adenergic Antagonist are in β Blockers are Metoprolol with percentage of 31.50%, In α blockers are prazosin with percentage of 26%, In α+β blocker are Carvedilol with percentage of 8.60%. Most commonly used ARB’s are Telmisartan with percentage of 6.50%, and ACE’s are Ramipril with percentage of 1%. Most commonly used central sympatholytics are Clonidine with percentage of 18.40%, Vasodilators are Minoxidil with percentage of 1%. Medication adherence have been done, In which patients with High Adherence are with percentage of 16.21%, Medium Adherence are with percentage of 45.94%, Low Adherence are with percentage of 37%. This is done by Morisky medication adherence scale 8.
CONCLUSION: We have concluded that the CCB’s, diuretics and β-blockers are the most commonly used anti-hypertensive classes in hypertensive patients with CKD. Use of anti-hypertensives in CKD patients does not deviate from the guidelines laid down by NKF KDOQI guidelines. The patients should be educated about the rational use of drugs to decrease medication adherence.
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