Systolic and Diastolic Blood Pressure Analysis in Each Etiology of Pra-Hemodialysis Chronic Kidney Disease

Abstract

Background: Hypertension which is frequently found in Chronic Kidney Disease(CKD), contributing to the accelerating of CKD progressivity. Recent epidemiological studies had shown that CKD were associated with hypertension at all stages, even in pra-hemodialysis stage. Despite this, population-based estimates of prevalence, potential etiologies, and awareness about hypertension in CKD are not available. Objective: Thus, we conducted a study to compare systolic and diastolic blood pressure profile in each etiologies among CKD patients. Methods: Cross-sectional study involving total sample from observational study between 1 January – 31 December 2012 in Dr. Soetomo General Hospital Surabaya. Subjects were all patients in outpatient wards presenting with pra-hemodialysis CKD. Descriptive studies and blood pressure analysis were conducted based on their etiologies. There were 418 subjects, 53,8% males and 46,2% females were observed and evaluated in clinical profiles. Results: From 418 CKD patients, 187 patients (44,7%; P < 0.05) had Diabetes Mellitus as their primary etiologies, 138 patients (33%; P < 0.05) had Hypertension as primary etiologies. Another CKD etiologies were Gout (21 subjects; 5,0%; P < 0.05), Glomerulonephritis & Lupus (20 subjects;4,8%; P < 0.05), Kidney & Urinary Tract Stone(17 subjects;4,0%), and Non-Stone Related Uropathy, i.e Cancer (17 subjects;4,0%; P < 0.05). Mean SBP/DBP level in Diabetes Kidney Disease groups is 138,06/77,25 mmHg (P < 0.01); in Hypertensive Kidney Disease groups is 156,76/83,74 mmHg; in Gout & Kidney Stone etiology is 137,41/80,11 mmHg; in Glomerulonephritis etiology is 131,95/81,5 mmHg (P < 0.01). Conclusion: Consistent with another studies, our research revealed that Diabetes Mellitus and Hypertension, which is the most dominant etiology of CKD, contributes to the greatest increase of both systolic and diastolic blood pressure. All etiologies of CKD showed hypertensive profile with different characteristic in each etiologies. Clinician should promptly identify CKD patients with high risk of being uncontrolled hypertension and treat them immediately and appropriately to prevent further damage to cardiovascular and other organs.