IMPACT OF DIURETIC USE ON BLOOD PRESSURE, AND RENAL FUNCTION IN PATIENTS WITH CHRONIC KIDNEY DISEASE AND HYPERTENSION

Abstract

Diuretics for the management of hypertension in the chronic kidney disease (CKD) population have been undervalued
against other classes of antihypertensive medications for years. This study aimed to determine the prevalence of diuretic
use, ascertain their prescribing pattern, and investigate their impact on blood pressure (BP) and renal function among
patients with CKD and hypertension. The study was a one-year retrospective longitudinal study that included patients
with CKD and hypertension who received care in a tertiary care hospital in Nigeria. A systematic random sampling
technique was applied to collect data. Paired-samples-t test was used to compare the mean BP, creatinine level, and
estimated glomerular filtration rate (eGFR) at baseline and three months, while the independent-t test was used to
compare the mean differences of these parameters between those that had diuretics with or without other
antihypertensive medications and those who had other antihypertensive medications, all at p < 0.05 statistically
significant level. The prevalence of diuretic use was 80.3% with loop diuretics (97.6%) as the most commonly
prescribed. Furosemide ranked first (77.8%) among all the individual diuretics prescribed. From baseline to 3 months,
systolic BP and diastolic BP were significantly decreased by 32.3 mmHg, P<0.001, and 12.8 mmHg, P<0.001,
respectively. Also, creatinine and eGFR were significantly decreased and increased by 180 μmol/L, P<0.001, and 1.7
mL/minutes/1.73m2, P<0.001, respectively. An overwhelming proportion of the study population was prescribed
diuretics mainly furosemide with or without other antihypertensive medications. Also, this study has shown that
diuretics can impact BP and renal function positively among patients with CKD and hypertension.