| Summary: | Hypertension and chronic kidney disease (CKD) are the two kinds of disease
that are related each others. Hypertension is not only a major cause of kidney
failure but also becomes a problem of dialysis patients. The prevalence of
hypertension is estimated to occur in 80% of the hemodialysis population.
Hypertension increases the risk of cardiovascular disease. Cardiovascular disease
and complications are known as the major cause of morbidity and mortality among
ESRD patients. In hemodialysis population, the target of pre-dialysis blood
pressure is <140/90 mmHg and for the post-dialysis is <130/80 mmHg. This
research aims to determine the relationship between the compliance levels of
patients in antihypertensive medication towards the blood pressure control of predialysis
outpatients with ESRD who undergo routine hemodialysis in RS PKU
Muhammadiyah Yogyakarta.
This research is conducted by using a descriptive observational study design
with prospective data collection method. Data analysis was performed to determine
the profile of antihypertensive therapy use, antihypertensive medication therapy
outcomes profile of the pre-dialysis blood pressure, and the influence of the
patients� compliance level in antihypertensive medication towards the blood
pressure control of pre-dialysis outpatients with ESRD who undergo routine
hemodialysis in RS PKU Muhammadiyah Yogyakarta. The patient compliance
level in taking antihypertensive drugs is assessed by questionnaire of Modified
Morisky Scale (MMS).
Based on the research results, the antihypertensive profile used was CCBs
system (32,91%), loop diuretics (23,42%), AIIRA (15,82%), central α agonists
(12,66%), ACEI (12,03 %), and β blockers (3,16%). Antihypertensive therapies
applied single and combination therapy. Mono-therapy applied ACEI group
(1,85%), CCBs (3,70%), and loop diuretics (1,85%). The most used
antihypertensive combination are 3 application, they are a combination of the class
of CCBs, AIIRA, and loop diuretics (16,67%). The outcomes profile of
antihypertensive medication therapy based on the measurement results of predialysis
blood pressure is the target of pre-dialysis blood pressure (<140/90
mmHg) can only be achieved by 3 patients, 2 patients are the compliance patients
with the right choice and appropriate dose of antihypertensive therapy and 1
patient is a non-adherent patient with incorrect type and inappropriate doses of
antihypertensive therapy. Most of hemodialysis patients have isolated systolic
hypertension (ISH). The influence of the patients� compliance level in
antihypertensive medication towards the blood pressure control of pre-dialysis
outpatients, there are 19 patients (35,19%) in the category of non-adherent patients
with a mean blood pressure is 168,40/ 91,95 mmHg, and 35 patients (64,81%) in
the category of adherence with a mean blood pressure is 165,60/ 87,77 mmHg.
|
|---|