Endocrine Abstracts

Objectives: To compare the non diabetic (nonDM; n=124) and diabetic (DM; n=63) patients on haemodialysis (HD) in terms of blood pressure(BP) control.

Methods: Retrospective case-note review of 187 HD patients. For statistical analysis the unpaired t-test was employed.

Results: Antihypertensive treatment was given to 58.8% of the nonDM and 82.5% of the DM group. In the nonDM and DM groups on antihypertensive treatment, systolic hypertension (HTN) was noted in 30.6 and 53.8% respectively. In patients not on antihypertensive drugs, systolic HTN was found in 8% of the nonDM group and 10% of the diabetics.

In the nonDM group, the mean systolic BP was 136.44 mmHg, pulse pressure (PP) was greater than 80 mmHg in 25% and the mean weight loss (WL) during HD was 1.56 kg. In the DM population, the mean systolic BP was 149.8 mmHg, PP was over 40 mmHg in 100% and over 80 mmHg in 63.5%. In the DM group the average WL was 1.94 kg.

In HD patients on antihypertensive treatment, multi-drug therapy (2 or more agents) was given to 66.6% of the nonDM and 67.6% of the DM group. In the nonDM group, calcium channel blockers (CCB) were used in 35.4%, beta blockers (BB) in 24.2% and angiotensin converting enzyme inhibitors (ACEi) in 21.2%. CCB was the most commonly used antihypertensive medication in DM (60.3%). BBs were used in 46% and ACEi in 31.7% of diabetics.

Conclusions: Despite antihypertensive treatment, more than half of the diabetic patients and almost one third of the non-diabetics failed to achieve control of their BP. PP was significantly raised in the DM population comparing to the non-diabetics (P<0.001). WL, although greater in diabetics, failed to contribute to their BP control. More diabetics were on therapy comparing to the nonDM group. Multi-drug therapy was given in more than 60% of the patients in both groups. CCB was the most commonly used drug in both groups. In diabetics BB were administered more frequently.