THE EFFECT OF ALLOPURINOL THERAPY ON BLOOD PRESSURE IN PATIENTS OF CHRONIC KIDNEY DISEASE WITH HYPERTENSION AND HYPERURICEMIA UNDERGOING HEMODIALYSIS

Abstract

Objective: To determine the effect of allopurinol therapy on blood pressure in patients of Chronic Kidney Disease with hypertension and hyperuricemia undergoing hemodialysis.

Study Design: Quasi experimental study.

Place and Duration of Study: Department of Medicine, Pak Emirates Military Hospital Rawalpindi, from Nov 2015 to May 2016.

Methodology: One hundred and seventy-two patients with the diagnosis of chronic kidney disease and on regular hemodialysis were selected after fulfilling the inclusion and exclusion criteria. The blood pressure of patient before and after dialysis was measured. The patients were given 100mg of allopurinol daily for three months. The blood pressure was checked weekly by the researcher before and after dialysis. The mean systolic and diastolic blood pressure before and after three months’ treatment were compared using paired-sample t-tests. The efficacy was defined as attainment of blood pressure <140/90 mmHg at two readings 24 hours apart. The McNemar test was applied to see the efficacy of treatment at three months.

Results: Mean age of the sample was 46.6 ± 6.1 years. Out of 172 patients, 51.7% were males while 48.3% were females. The mean duration of chronic kidney disease was 3 ± 1.3 years. The mean systolic blood pressure was 160.7 ± 11.8 mmHg while diastolic blood pressure was 105.7 ± 8.8 mmHg at the start of study period. At the end of three months, the systolic and diastolic blood pressures were 139.6 ± 11.2 mmHg and 96.4 ± 13.6 mmHg respectively. At the endpoint, a significant number (113, 65.7%, p<0.001) of patients had blood pressure in the desired values i.e. <140/90 mmHg. The effect modifiers like age, gender, and duration of chronic kidney disease were tabulated against efficacy and the differences were found insignificant.

Conclusion: Allopurinol was effective for the control of blood pressure in our sampled patients, who were hypertensive and hyperuricemic and were undergoing regular hemodialysis.