Blood Pressure Control and its Determinants among Patients with Chronic Kidney Disease in a Nigeria Tertiary Hospital: A Cross-Sectional Study

Abstract

Background: Hypertension is a common cardiovascular risk factor associated with adverse renal and cardiovascular outcomes in chronic kidney disease  patients. Significant reduction in these adverse outcomes could be achieved through adequate blood pressure control in those with hypertension. This  study aimed to determine the prevalence of poor blood pressure control and associated factors among chronic kidney disease patients with hypertension  in a Nigerian tertiary hospital.

Methodology: This was a cross-sectional study that determined the prevalence of poor blood pressure control and its associated factors among chronic  kidney disease patients with hypertension. Poor blood pressure control was defined as blood pressure ≥ 140/90mmHg. Factors associated with blood  pressure control were determined on multivariate analysis. P-value less than 0.05 was considered significant.

Results: A total of 494 chronic kidney disease patients with hypertension were studied. The mean age of patients was 48.77+13.06 with a range of 17-95  years. There were 303 (61.3%) males and 191 (38.7%) females. A total of 44.5% of the patients had end-stage renal disease while all patients were on  antihypertensive medications. The common causes of chronic kidney disease were hypertension (35%), diabetes mellitus (26.5%), and chronic  glomerulonephritis (12.1%).Poor blood pressure control was found in 74.4% of chronic kidney disease patients. The predictors of poor blood pressure  control were age (AOR: 0.65; CI: 0.45-0.94; p=0.02), use of multiple anti-hypertensives (AOR: 1.99; CI: 1.36-2.90; p=<0.001) and the presence of significant  proteinuria (AOR: 1.47; CI: 1.02-2.14; p=0.04).

Conclusion: The majority of patients with chronic kidney disease had poor blood pressure control. Those who were young had significant proteinuria,  and those who used≥ 3 antihypertensive medications were more likely to have poor blood control. There is a need to optimize BP management in chronic  kidney disease patients in order to reduce adverse outcomes.