Blood pressure control is hard to achieve in patients with chronic renal failure: results from a survey of renal units in Norway.
OBJECTIVE
To assess the use of antihypertensive drugs and blood pressure (BP) levels in relation to current guidelines for BP control in patients with chronic renal failure (CRF).


METHODS
A cross-sectional survey was carried out in six renal outpatient clinics in Oslo and the surrounding area. The hospital records of all renal patients not yet in need of renal replacement therapy and with serum creatinine>or=200 micromol/l who attended consultations with nephrologists regularly (at least every third month) were reviewed.


RESULTS
Of the 351 patients, 97% had hypertension. the majority of patients (96%) were receiving antihypertensive therapy. The average number of antihypertensive drugs being taken was 2.7+/-1.3 (median 3), but it varied with the cause of CRF. The drugs most frequently prescribed as monotherapy were angiotensin-converting enzyme inhibitors or angiotensin II receptor antagonists, which were used by 32%; 51% of patients were using three or more antihypertensive drugs. Loop diuretics were prescribed as monotherapy in 25% of cases and in combination with two or more other drugs in 87%. Age and serum creatinine levels influenced the choice of antihypertensive therapy. The target BP of <130/80 mmHg was obtained in 13% of patients, and lack of optimal BP control was mainly due to systolic hypertension. A total of 38% of patients had a BP of <140/90 mmHg, while 58% failed to achieve a systolic BP of <140 mmHg.


CONCLUSIONS
Optimal blood pressure control is hard to achieve in patients with CRF, even with specialist care and the use of multiple antihypertensive drugs.
Prøsch
Line Katrine
LK
Department of Pharmacotherapeutics, University of Oslo, Norway.
Saelen
Marie Grøn
MG
Gudmundsdottir
Helga
H
Dyrbekk
Dagfinn
D
Hunderi
Odd Helge
OH
Arnesen
Erik
E
Paulsen
Dag
D
Skjønsberg
Helge
H
Os
Ingrid
I
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D003430:Cross-Sectional Studies; D004363:Drug Utilization; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000503:physiopathology / Q000517:prevention & control*; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000503:physiopathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D009664:Norway; D012189:Retrospective Studies
D000959:Antihypertensive Agents