Author(s): Nazma, Syeda Zuleqaunnisa Begum, Mohammed Fareedullah, Shaik Abdul Kareem, Anjum Fatima, Asfia Firdous, Sulaiman Abdul Majeed

Email(s): najju.2k3@gmail.com , syedazuleqaunnisa@gmail.com

DOI: 10.52711/0974-360X.2025.00187   

Address: Nazma1, Syeda Zuleqaunnisa Begum2, Mohammed Fareedullah3, Shaik Abdul Kareem4, Anjum Fatima4, Asfia Firdous4, Sulaiman Abdul Majeed4
1Professor, Department of Nephrology, Owaisi Hospital and Research Centre.
2Assistant Professor, Department of Pharmacy Practice, Deccan School of Pharmacy.
3Associate Professor, Department of Pharmacy Practice, Deccan School of Pharmacy.
4Pharm. D Student, Deccan School of Pharmacy.
*Corresponding Author

Published In:   Volume - 18,      Issue - 3,     Year - 2025


ABSTRACT:
Refractory hypertension (RfHTN) presents a challenge in managing patients with chronic kidney disease (CKD) and undergoing maintenance haemodialysis (MHD). Hypertension exacerbates kidney function loss and adversely impacts CKD patients' quality of life. In order to enhance the quality of life for patients with stage-V chronic kidney disease (CKD) receiving maintenance hemodialysis, the study set out to detect, define, and treat refractory hypertension (RfHTN). A six-month prospective observational study was carried out at a tertiary care hospital's outpatient dialysis unit. Patients with CKD on MHD and uncontrolled blood pressure (BP) despite =5 antihypertensive medications were enrolled. BP monitoring pre- and post-dialysis was performed thrice weekly. The effect of antihypertensive agents was evaluated using symptom frequency, target BP, medication adherence (MMAS-8 Score), kidney disease quality of life (KDQOL-36 score), and adverse effects monitoring. 50 participants were enrolled, with a higher percentage of male patients (60%). Significant differences in systolic BP and pulse rate were observed pre and post-dialysis. In our research, approximately 48% of the participants fell within the adult age range (25 to 65 years), while only 2% were classified as elderly, aged (65 years and above). In the BMI distribution, a significant portion of patients showed diverse weight categories: 18% were underweight, 64% fell within the normal weight range, 16% were overweight, and 2% were classified as obese.A notable variation in hemoglobin levels across all patients was reported, which might contribute to poor kidney function and challenges in managing blood pressure among them. A significant contrast was noted in the MMAS-8 score between the initial evaluation and the subsequent follow-up assessments. a significant variance was noted in the MMAS-8 score between the initial and follow-up evaluations. Medication adherence was found to correlate with improved BP control. Higher KDQOL-36 scores indicated better health-related quality of life. In managing hypertension in MHD patients, angiotensin II receptor blockers (ARBs) proved effective, alongside dietary salt restrictions and appropriate diuretic therapy. Hypertensive MHD patients face increased cardiovascular and renal risks, emphasizing the importance of maintaining normal BP.


Cite this article:
Nazma, Syeda Zuleqaunnisa Begum, Mohammed Fareedullah, Shaik Abdul Kareem, Anjum Fatima, Asfia Firdous, Sulaiman Abdul Majeed. Research Journal of Pharmacy and Technology. 2025;18(3):1290-5. doi: 10.52711/0974-360X.2025.00187

Cite(Electronic):
Nazma, Syeda Zuleqaunnisa Begum, Mohammed Fareedullah, Shaik Abdul Kareem, Anjum Fatima, Asfia Firdous, Sulaiman Abdul Majeed. Research Journal of Pharmacy and Technology. 2025;18(3):1290-5. doi: 10.52711/0974-360X.2025.00187   Available on: https://rjptonline.org/AbstractView.aspx?PID=2025-18-3-48


REFERENCES:
1.    Elaine Ku, Benjamin J. Lee, Jenny Wei, Matthew R. Weir. Hypertension in CKD: Core Curriculum. American Journal of Kidney Disease. 2019; 74(1) doi: 10.1053/ j.ajkd.2018.12.044.
2.    Eric Judd, David A. Calhoun. Management of Hypertension in CKD: Beyond the Guidelines. Advances in Chronic Kidney Disease. 2015; 22(2). https://doi.org/10.1053/j.ackd.2014.12.001.
3.    Acelajado MC, Hughes ZH, Oparil S, Calhoun DA. Treatment of Resistant and Refractory Hypertension. Circ Res. 2019; 124(7): 1061-1070. doi: 10.1161/CIRCRESAHA.118.312156
4.    Maria Czarina Acelajado, Zachary H. Hughes, Suzanne Oparil and David A. Calhoun. Treatment of Resistant and Refractory Hypertension. AHA Journals; 2019: 124: 1061–1070doi:10.1161/CIRCRESAHA.118.312156.
5.    Taniyama, Y. Management of hypertension for patients undergoing dialysis therapy. Ren Replace Ther.  2016; 2(21). https://doi.org/10.1186/s41100-016-0034-2.doi:10.1186/s41100-016-0034-2.
6.    Matanes, Faris and Khan, M. and Siddiqui, Mohammed and Dudenbostel, Tanja and  Calhoun, David and Oparil, Suzanne.  An Update on Refractory Hypertension. Current Hypertension Reports. 2022 doi: 10.1007/s11906-022-01185-6.
7.    Mc Causland FR, Waikar SS, Brunelli SM. Increased dietary sodium is independently associated with greater mortality among prevalent hemodialysis patients. Kidney Int. 2012; 82(2): 204–11. doi:10.1038/ki.2012.42.
8.    Hirakata H, Nitta K, Inaba M, et al. Japanese Society for Dialysis Therapy guidelines for management of cardiovascular diseases in patients on chronic hemodialysis. TherApher Dial. 2012; 16(5): 387–435. doi:10.1111/j.1744-9987.2012. 01088.x.
9.    Levin NW, Kotanko P, Eckardt K-U, et al. Blood pressure in chronic kidney disease stage 5D-report from a kidney disease: improving global outcomes controversies conference. Kidney Int. 2010; 77(4): 273–84. doi:10.1038/ki.2009.469.
10.    Mohamad M, Moussally K, Lakis C, El-Hajj M, Bahous S, Peruzzo C, Reid A, Edwards JK. Self-reported medication adherence among patients with diabetes or hypertension, Médecins Sans Frontières Shatila refugee camp, Beirut, Lebanon: A mixed-methods study. PLoS One. 2021; 16(5): e0251316. doi: 10.1371/journal.pone.0251316
11.    Almulhim MY, Alkuwaiti AA, Alhabrati AY, et al. Relationship Between Nutritional Parameters and Quality of Life in Patients with End-Stage Kidney Disease on In-Centre Haemodialysis in Al-Ahsa, Saudi Arabia. Cureus. 2022; 14(12): e32146. doi: 10.7759/cureus.32146.
12.    Achsa Thomas, Julia S. Jacob, Merin Abraham, Blessy M. Thomas, Purnima Ashok. Assessment of Acute complications and Quality of Life in Hemodialysis patients with Chronic Kidney Disease. Research Journal of Pharmacy and Technology. 2021; 14(5): 2671-5. doi: 10.52711/0974-360X.2021.00471
13.    Vo, Trung and Tran, Thai and Duong, Khanh and Pham, Khang. impact of Chronic Kidney Disease on Health-Related Quality of Life: A Prospective Observational Study using the Kdqol-36 Instrument: Journal of Clinical and Diagnostic Research. 2018. doi: 10.7860/JCDR/2018/36694.11708.
14.    Christina Pothen, Bibin Baby, Anusree Ashokan, Chinju Chacko, Pradeep Shenoy, Nandakumar UP. Drug Usage Pattern in Chronic Kidney Disease patients undergoing maintenance Hemodialysis. Research J. Pharm. and Tech. 2019; 12(10): 5024-5028. doi: 10.5958/0974-360X.2019.00872.2
15.    Dudenbostel T, Acelajado MC, Pisoni R, Li P, Oparil S, Calhoun DA. Refractory Hypertension: Evidence of Heightened Sympathetic Activity as a Cause of Antihypertensive Treatment Failure. Hypertension. 2015; 66(1): 126-33.doi: 10.1161/HYPERTENSIONAHA.115.05449
16.    Hays, R.D., Kallich, J.D., Mapes, D.L. et al. Development of the Kidney Disease Quality of Life (KDQOLTM) Instrument. Qual Life Res. 1994; 3: 329–338. https://doi.org/10.1007/BF00451725. doi: 10.1007/BF00451725.
17.    Flythe JE, Chang TI, Gallagher MP, Lindley E, Madero M, Sarafidis PA, Unruh ML, Wang AY, Weiner DE, Cheung M, Jadoul M, Winkelmayer WC, Polkinghorne KR. Conference Participants. Blood pressure and volume management in dialysis: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference. Kidney Int. 2020; 97(5): 861-876. doi: 10.1016/j.kint.2020.01.046.
18.    K/Doqi Clinical Practice Guidelines For Cardiovascular Disease In Dialysis Patients. 2005; 45(Supplement 3): 16-153 doi: https://doi.org/10.1053/j.ajkd.2005.01.019


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