N-005 PREDICTORS OF ADEQUATE CONTROL OF HYPERTENSION AMONG OUT-PATIENT CHRONIC KIDNEY DISEASE PATIENTS (PREACH-CKD) IN THE PHILIPPINE GENERAL HOSPITAL

Abstract

Background Hypertension is both a cause and a complication of chronic kidney disease(CKD). The National Kidney Foundation Kidney Disease Outcome and Quality Initiativerecommends a blood pressure(BP) goal of < 130/80 mmHg in CKD patients. We performed this study to describe the clinical profile of adult patients with hypertension and CKD seen at the Nephrology Out-patient Clinic of the Philippine General Hospital, to compare the clinical characteristics of patients with controlled versus uncontrolled hypertension, and to correlate the clinical characteristics with adequate BP control. Methods All patients with CKD seen in November 2010 were included. Baseline demographics, blood pressure, medication, and laboratory data were obtained and analyzed using logistic regression. Results There were 142 patients included. Controlled BP by general definition (<140/90) and disease-specific definition (<130/80) were 47.9% and 19.01%, respectively. The mean systolic BP was 134.37(+18.31) mmHg and the mean diastolic BP was 80.63(+9.9) mmHg. Hypertensive nephropathy (42.3%) was the most common etiology of CKD. The mean serum creatinine was 342.95 mmol/L(+328.25) with most patients being at stage 5 CKD (31.7%). Univariate analysis revealed that female gender (OR 0.41, 95% CI 0.17–0.99, p = 0.049) was significantly associated with better BP control while the use of dihydropyridine CCB (OR 2.36, 95% CI 1.00–5.54, p = 0.040) and the presence of LVH (OR 6.21, 95% CI 1.69–22.78, p = 0.048) by 2DE were significantly associated with poor BP control. On multivariate analysis, none of the above mentioned clinical characteristics were significantly associated with BP control. Conclusions We have presented the clinical profile of out-patient adult hypertensives with CKD at our institution. The disease-specific proportion of patients with adequate BP control is 19.01%. Female gender is associated with good BP control while LVH by 2DE, and the use of dihydropyridine CCB were significantly associated with poor BP control on univariate analysis. On multivariate analysis, no significant predictor of adequate BP control was identified among the population studied.