Clinical audit improves hypertension control in hemodialysis patients

Pasquale Esposito, Attilio Di Benedetto, Carmine Tinelli, Annalisa De Silvestri, Teresa Rampino, Daniele Marcelli, Antonio Dal Canton

Research output: Contribution to journalArticlepeer-review

Abstract

Background: In patients on hemodialysis (HD), hypertension is a risk factor for cardiovascular disease. In this study we tested the effectiveness of a clinical audit in improving blood pressure (BP) control in HD patients. Methods: 177 adult, prevalent patients undergoing dialysis in NephroCare centers in Italy were audited. At the conclusion of the audit, individual strategies were developed in order to improve BP control. Patient data was collected and examined at months -1 (Pre), 0 (the date of the audit- Audit), and +1 and +6 after the audit (Post-1 and Post-6, respectively). We recorded BP, information on factors affecting BP, and anti-hypertensive drug regimen. The primary outcome of the study was to decrease prevalence of hypertension (BP≥140/90 mmHg). Secondary outcomes were a reduction in average BP in hypertensive patients and/or a decrease in drug delivery associated with lower or unchanged BP. Results: 104 patients out of 177 (58.7%) were hypertensive at Audit. BP levels were directly related to comorbidity and male sex, and inversely related to dialysate sodium concentration. The announcement of the audit alone was associated with a decreased prevalence of hypertension (Pre 64.4% to Audit 58.7%); a further decrease followed the audit (Post-1 51.1%, Post-6 47.6%, p

Original languageEnglish
Pages (from-to)305-313
Number of pages9
JournalInternational Journal of Artificial Organs
Volume36
Issue number5
DOIs
Publication statusPublished - May 2013

Keywords

  • Clinical audit
  • Dry weight
  • Hemodialysis
  • Hypertension
  • Quality improvement strategies

ASJC Scopus subject areas

  • Biomaterials
  • Biomedical Engineering
  • Bioengineering
  • Medicine (miscellaneous)

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