Abstract

Cardiac problems are the foremost reason for morbidity and mortality in patients with end-stage renal disease caused by hemodialysis. Many of these patients suffer from increased blood pressure, and acceptable control of blood pressure is a task in these patients because of multifactorial etiology. The present study aims to find out the best possible drug or combination of drugs that can better control blood pressure and improve the quality of life of these patients. It is a multi-centered retrospective study design it was accessed in the patients who visited the Haemodialysis unit of Nephrology unit of Mahatma Gandhi Memorial Hospital, Warangal and Vishwas Super Speciality Hospital, Hanamkonda. The collected data related to demographic characteristics, comorbidities, clinical pathology parameters, current therapy of antihypertensive drugs and blood pressure control (pre-dialysis and post-dialysis) were noted and analysed. 56.60 % of patients on hemodialysis who are suffering from hypertension with the age group of 41-60 y (46.47 %) majority of the population was illiterates with a count of 210 (37.97 %) and business people were of 196 (35.44 %). A combination of amlodipine with metaprolol most frequently prescribed agents (31.82 %), it was significantly (p<0.0001) reducing the systolic blood pressure and diastolic blood pressure in intra (142.80±14.49; 75.13±7.56), post-dialysis (122.29±10.81; 67.91±7.64) respectively compared with pre-dialysis (161.72±14.78; 81.66±.6.99). The mean intradialytic weight gain was 2.65 kg. In post dialysis treatment, the greatest mean (95 % confidence interval) changes in creatinine (p<0.0353), albumin (p<0.0001), Kt/v (p<0.0001 and mean arterial pressure reduced (p<0.0001) in post-dialysis compared to pre-dialysis respectively. The combination of amlodipine with metaprolol frequently prescribed medication provides adequate blood pressure control in all phases of dialysis with the least intra-dialysis complication.