Factors Associated with Poor Blood Pressure Control in Patients with Advanced Chronic Kidney Disease at the Borgou Departmental Teaching Hospital (Benin)

Abstract

Background: This study aimed to investigate factors associated with poor blood pressure control in patients with advanced chronic kidney disease (CKD) managed at the nephrology department of the departmental teaching hospital of Borgou (CHUD-B) in Benin in 2023. Methods: We conducted a longitudinal follow-up study involving patients with advanced CKD admitted to the nephrology department of CHUD-B from January 1, 2021, to September 30, 2023. The follow-up period was 12 months. Sampling was exhaustive. CKD was classified according to the KDIGO 2012 criteria, while hypertension and its progression were assessed based on the KDIGO 2021 criteria. Factors associated with poor blood pressure control were identified using logistic regression analysis, with statistical significance set at p < 0.05. Results: Among the 146 patients included, 106 (72.6%) had hypertension. Systolic-diastolic hypertension was most common (75.5%), and Grade 1 hypertension was predominant (38.7%). Patients were followed for at least six months; blood pressure targets were achieved in half of the hypertensive patients, mostly within six months. Angiotensin-converting enzyme inhibitors (ACEis) are the most prescribed antihypertensive drugs. In the multivariate analysis, potassium supplementation (p = 0.02), poor treatment adherence (p = 0.012), and missed follow-up appointments (p = 0.034) were independently associated with poor blood pressure control. Conversely, the use of ACE inhibitors was significantly associated with better control (p = 0.043). Conclusion: The prognosis of hypertension in advanced CKD depends on management. Adequate management is essential, as is the use of new-generation drugs.