| Objective To analysis the prevalence and control of hypertension with chronic kidney disease(CKD)patients,the use of antihypertensive drugs,and factors associated with uncontrolled hypertension.Methods Selected patients from January 2014 to November 2016 who were hospitalized in the department of nephrology from The First Affiliated Hospital of Soochow University,and diagnosed of CKD conformed to the diagnostic code in the kidney dialysis outcomes quality(K/DOQI),record the general situation,the average blood pressure of three days before discharge,antihypertensive medication during hospitalization and related biochemical indicators.The data was analyzed by SPSS statistical software,?~2test was used to compare the rate,and multivariable logistic regression was used to explore the factors associated with uncontrolled hypertension.Results(1)1461 patients were included in the analysis,in which male was 801,female was 660,and the male-female ratio was 1.21:1.Primary glomerulonephritis were the most common cause of CKD patients,accounted for 53.1%,followed by hypertensive nephropathy(10.4%)and diabetic nephropathy(7.6%).Patients in CKD1-5 stages counted for 27.79%,14.37%,16.97%,9.92%and 30.94%,respectively.(2)The prevalence rate of hypertension in patients with CKD was 81.6%,which was increased gradually with the decline of the renal function and the growth of the age,and the rate of male was higher than female(85.9%vs 76.4%,P(27)0.001).(3)97.2%of patients were aware of hypertensive diagnosis and 92.5%of patients had been treated with antihypertensive drugs.Among the hypertensive patients with CKD,7.5%of which had not been treated with antihypertensive drugs,37.5%,30.1%,16.0%,6.2%and 2.7%of which used 1,2,3,4,and?5antihypertensive drugs,respectively.The most common use of antihypertensive medication was calcium channel blocker(CCB),accounted for 73.6%,the second common was angiotensin II receptor blocker(ARB)(50.2%),27.7%of participants took beta blocker.(4)The hypertensive control rate in hypertensive patients with CKD was 48.8%(BP(27)140/90mmHg)and 22.6%(BP(27)130/80mmHg),and with the decline of the renal function,the control rate decreased gradually.The hypertensive control rate of diabetic nephropathy was the lowest,only accounted for 27.3%(BP(27)140/90mmHg)and 10.0%(BP(27)130/80mmHg).(5)Compared with non-dialysis patients,the prevalence and awareness rate of hypertension with dialysis patients was significantly higher(98.5%vs77.7%,P(27)0.001;99.6%vs 96.5%,P(27)0.05),while the proportion of hypertensive treatment had no significant difference(94.1%vs 92.1%,P>0.05).To the contrary,non-dialysis patients had a higher rate of hypertensive control compared with dialysis patients.(BP(27)140/90mmHg,51.7%vs 38.9%,P(27)0.001 and BP(27)130/80mmHg,24.8%vs 14.8%,P(27)0.05).(6)Multivariate Logistic regression analysis showed that the increased of body mass index(BMI)(OR=1.044,95%CI 1.000~1.089),pulse pressure(OR=1.135,95%CI1.117~1.153)and 24 hours urinary albumin(OR=1.272,95%CI 1.131~1.431)was associated with inadequate blood pressure control.Conclusions(1)Primary glomerulonephritis were the most common cause of CKD patients,followed by hypertensive nephropathy and diabetic nephropathy.(2)The prevalence rate of hypertension in patients with CKD was high,which was increased gradually with the decline of the renal function and the growth of the age.(3)The single antihypertensive medication and two kinds combination was commo n,with CCB and ARB were the most frequently prescribed drug.The use of the combination of three or more antihypertensive medication was less widely.(4)The control rate of hypertension in patients with chronic kidney disease is low,which was gradually reduced with the progress of kidney disease.(5)The prevalence of hypertension in dialysis patients is high,but the control of that was inadequate.(6)The increased of BMI,pulse pressure and 24 hours urinary albumin were associated with inadequate blood pressure control. |
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