USE OF ANTIHYPERTENSIVES IN PATIENTS HAVING ASSOCIATED RENAL PARENCHYMAL DISORDERS: CROSS SECTIONAL PRESCRIPTION PATTERN STUDY IN A TERTIARY CARE HOSPITAL
Abstract
Hypertension is both a cause and a consequence of renal parenchymal disease. Once detected, formulation of an appropriate therapeutic strategy is imperative to not only control hypertension, but also to retard the progression of the renal pathology. Judicious and optimal use of the available antihypertensive agents is of utmost importance. This study aims at analyzing the influence of current guidelines on prescribing in this particular subset of patients. Case history of patients having hypertension comorbid with renal pathological disorders was noted down from the medical records department. A total of 58 prescriptions thus noted were analysed on the basis of antihypertensive agents that were prescribed. The CCB’s were the group of drugs prescribed the most in renal disease associated hypertension (79%) followed by the diuretics (48%).The ACE‐inhibitors and ARB’s were prescribed in around 34% of the patients. Amlodipine and Frusemide were the most frequently used individual agents.
Keywords:
Antihypertensives, Prescription pattern, Renal parenchymal disease, Joint National Committee Guidelines, Pharmacoepidemiological study.DOI
https://doi.org/10.25004/IJPSDR.2011.030319References
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3. Iseki K, Ikemiya Y, Fukiyama K. Blood pressure and risk of end-stage renal disease in a screened cohort. Kidney Int 1996; 49(Suppl 55): s 69-71.
4. Ritz E, Rambausck M, Masslacher C, Mann J. Pathogenesis of hypertension in renal disease. AM J Nephrol 1989; 9:85-90.
5. Krolewski AS, Canessa M, Warran JH, Laffel LMB, Chrislich AR, Knowler WC, et al. Predisposition to hypertension and susceptibility to renal disease in insulin dependent diabetes mellitus. N Engl J Med. 1988; 318:140-145.
6. Bergstrom J, Alvestrand A, Bucht H, Gutlerrez A. Progression of chronic renal failure in man is retarded with more frequent clinical follow- ups and better blood pressure control. Clin Nephrol. 1986; 25:1-6.
7. JNC-6. The Sixth report of the Joint National Committee on detection, education and treatment of high blood pressure. Arch Intern Med. 1997; 157:2417.
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9. Preston RA, Singer I, Epstein M. Renal parenchymal hypertension: current concepts of pathogenesis and management. Arch Intern Med. 1996; 156:602-611.
10. Smith MC, Dunn MJ. Hypertension in renal parenchymal disease. In: Laragh JH, Brenner BM, eds. Hypertension: pathophysiology, diagnosis and management. New York, NY: Raven press; 1995:2081-2082.
11. Lowenthal DT, Dickerman D. The use of diuretics in varying degrees of renal impairment: an overview. Clin Exp Hypertens. 1983; 5:297-307
12. Voelker JR, Cartwright-Brown D, Anderson S, Leinfelder J, Sica DA, Kokko JP. Comparison of loop diuretics in patients with chronic renal insufficiency. Kidney Int. 1987; 32:572-578.
13. Kincaid-Smith P, Whitworth JA. Pathogenesis of hypertension in chronic renal disease. Semin Nephrol. 1988; 8:155-162.
14. Walker WG. Hypertension related renal injury: a major contributor to end stage renal disease. Am J Kidney Dis. 1993; 22:164-173.
15. Jafar TH, Schmid CH, Landa M, Giatrus I, Toto R, Remuzzi G, et al. Angiotensin converting enzyme inhibitors and progression of non diabetic renal disease: a meta-analysis of patient level data. Ann Intern Med. 2001; 135:73-87.
16. Meyer TW, Anderson S, Rennke HG, Brenner BM. Reversing glomerular hypertension stabilizes established glomerular injury. Kidney Int. 1987; 31:752-759.
17. Laher MS, Kelly JG, Doyle GD, et al. Pharmacokinetics of amlodipine in renal impairment. J Cadiovasc Pharmacol. 1988; 12 (suppl 7) 60-63.
18. Ter Wee P, De Michelli AG, Epstein M. Effects of calcium antagonists on renal hemodynamics and progression of nondiabetic chronic renal disease. Arch Intern Med. 1994; 154:1185-1202.
19. Lewis EJ, Hunsicker LG, Bain RP, Rohde RD, for the Collaborative Study Group. The effect of angiotensin converting enzyme inhibition on diabetic nephropathy. N Engl J Med. 1993; 329:1456-1462.
20. Maschio G, Alberti D, Janin G, et al. For the Angiotensin Converting Enzyme inhibition in Progressive Renal Insufficiency Study Group. Effect of the angiotensin converting enzyme benazepril on the progression of chronic renal insufficiency. N Engl J Med. 1996; 334:939-945.
21. Giatrus I,Lau J, Levey AS. Effect of angiotensin converting inhibitors on the prodression of non-diabetic renal disease: a metaanalysis of randomized trials. Ann Intern Med. 1997; 127:337-345.
2. Klag MJ, Whelton PK, Neaton JD, Brancati FL, Ford CE, et al. Blood pressure and end stage renal disease in men. N Engl J Med. 1996; 334:13-18.
3. Iseki K, Ikemiya Y, Fukiyama K. Blood pressure and risk of end-stage renal disease in a screened cohort. Kidney Int 1996; 49(Suppl 55): s 69-71.
4. Ritz E, Rambausck M, Masslacher C, Mann J. Pathogenesis of hypertension in renal disease. AM J Nephrol 1989; 9:85-90.
5. Krolewski AS, Canessa M, Warran JH, Laffel LMB, Chrislich AR, Knowler WC, et al. Predisposition to hypertension and susceptibility to renal disease in insulin dependent diabetes mellitus. N Engl J Med. 1988; 318:140-145.
6. Bergstrom J, Alvestrand A, Bucht H, Gutlerrez A. Progression of chronic renal failure in man is retarded with more frequent clinical follow- ups and better blood pressure control. Clin Nephrol. 1986; 25:1-6.
7. JNC-6. The Sixth report of the Joint National Committee on detection, education and treatment of high blood pressure. Arch Intern Med. 1997; 157:2417.
8. JNC-7. The Seventh Report of the Joint National Committee on prevention, detection, evaluation and treatment of high blood pressure. The JNC 7 Report. JAMA 2003; 289:2563.
9. Preston RA, Singer I, Epstein M. Renal parenchymal hypertension: current concepts of pathogenesis and management. Arch Intern Med. 1996; 156:602-611.
10. Smith MC, Dunn MJ. Hypertension in renal parenchymal disease. In: Laragh JH, Brenner BM, eds. Hypertension: pathophysiology, diagnosis and management. New York, NY: Raven press; 1995:2081-2082.
11. Lowenthal DT, Dickerman D. The use of diuretics in varying degrees of renal impairment: an overview. Clin Exp Hypertens. 1983; 5:297-307
12. Voelker JR, Cartwright-Brown D, Anderson S, Leinfelder J, Sica DA, Kokko JP. Comparison of loop diuretics in patients with chronic renal insufficiency. Kidney Int. 1987; 32:572-578.
13. Kincaid-Smith P, Whitworth JA. Pathogenesis of hypertension in chronic renal disease. Semin Nephrol. 1988; 8:155-162.
14. Walker WG. Hypertension related renal injury: a major contributor to end stage renal disease. Am J Kidney Dis. 1993; 22:164-173.
15. Jafar TH, Schmid CH, Landa M, Giatrus I, Toto R, Remuzzi G, et al. Angiotensin converting enzyme inhibitors and progression of non diabetic renal disease: a meta-analysis of patient level data. Ann Intern Med. 2001; 135:73-87.
16. Meyer TW, Anderson S, Rennke HG, Brenner BM. Reversing glomerular hypertension stabilizes established glomerular injury. Kidney Int. 1987; 31:752-759.
17. Laher MS, Kelly JG, Doyle GD, et al. Pharmacokinetics of amlodipine in renal impairment. J Cadiovasc Pharmacol. 1988; 12 (suppl 7) 60-63.
18. Ter Wee P, De Michelli AG, Epstein M. Effects of calcium antagonists on renal hemodynamics and progression of nondiabetic chronic renal disease. Arch Intern Med. 1994; 154:1185-1202.
19. Lewis EJ, Hunsicker LG, Bain RP, Rohde RD, for the Collaborative Study Group. The effect of angiotensin converting enzyme inhibition on diabetic nephropathy. N Engl J Med. 1993; 329:1456-1462.
20. Maschio G, Alberti D, Janin G, et al. For the Angiotensin Converting Enzyme inhibition in Progressive Renal Insufficiency Study Group. Effect of the angiotensin converting enzyme benazepril on the progression of chronic renal insufficiency. N Engl J Med. 1996; 334:939-945.
21. Giatrus I,Lau J, Levey AS. Effect of angiotensin converting inhibitors on the prodression of non-diabetic renal disease: a metaanalysis of randomized trials. Ann Intern Med. 1997; 127:337-345.
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01-07-2011
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“USE OF ANTIHYPERTENSIVES IN PATIENTS HAVING ASSOCIATED RENAL PARENCHYMAL DISORDERS: CROSS SECTIONAL PRESCRIPTION PATTERN STUDY IN A TERTIARY CARE HOSPITAL”. International Journal of Pharmaceutical Sciences and Drug Research, vol. 3, no. 3, July 2011, pp. 256-9, https://doi.org/10.25004/IJPSDR.2011.030319.
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How to Cite
“USE OF ANTIHYPERTENSIVES IN PATIENTS HAVING ASSOCIATED RENAL PARENCHYMAL DISORDERS: CROSS SECTIONAL PRESCRIPTION PATTERN STUDY IN A TERTIARY CARE HOSPITAL”. International Journal of Pharmaceutical Sciences and Drug Research, vol. 3, no. 3, July 2011, pp. 256-9, https://doi.org/10.25004/IJPSDR.2011.030319.
