Publication:

Hypertension management in chronic kidney disease: insights from a multicenter survey of nephrologists in India

Background Due to inadequate treatment adherence, delayed diagnosis, and a lack of healthcare resources, managing hypertension (HT) in patients with chronic kidney disease (CKD) in many regions of India is really difficult. This survey looks at ways to improve care through lifestyle changes, guideline-based interventions, and evidence-based practices.

Methods "A cross-sectional, structured, multicenter survey of 304 nephrologists across India was conducted from August to November 2024. A questionnaire was developed to gather valuable insights into their clinical practices and preferences concerning the diagnosis and management of HT in CKD patients.

Results Personalized approaches utilizing ACE inhibitors, ARBs, and CCBs for renal and cardiovascular benefits are necessary for the effective management of HT in CKD. Preventing the progression of CKD requires addressing non-adherence and enhancing patient education. Although they reduced proteinuria, combination treatments involving ACE inhibitors and ARBs raised safety questions. Nephrologists highlighted the clinical benefits of using specific medications in patients with CKD, especially for their effectiveness in managing related comorbidities and slowing the progression of the disease, despite difficulties with dosing and monitoring.

Conclusions The survey reveals varied treatment approaches to HT in CKD, highlighting key challenges like poor adherence and resistant HT. It emphasizes the need for personalized care, early detection, and integrated multidisciplinary management.