DOI: https://doi.org/10.14710/nmjn.v12i1.42659

Blood Pressure Control and Its Determinants among Patients with Non-Dialysis Chronic Kidney Disease in Myanmar

Ei Su Mon orcid  -  Master of Nursing Science Program (International Program), Faculty of Nursing, Mahidol University, Thailand
*Aurawamon Sriyuktasuth orcid  -  Department of Medical Nursing, Faculty of Nursing, Mahidol University, Thailand
Warunee Phligbua orcid  -  Department of Medical Nursing, Faculty of Nursing, Mahidol University, Thailand
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Abstract

Background: Controlling blood pressure is critical for patients with non-dialysis chronic kidney disease to prevent the rapid progression to end-stage renal disease and sudden cardiac death. However, only a limited number of these patients achieve the blood pressure target. No previous study has been observed to evaluate the status of blood pressure control and its determinants among Myanmar patients with non-dialysis chronic kidney disease.

Purpose: This study aimed to identify the rate of blood pressure control and its determinants among patients with non-dialysis chronic kidney disease in Myanmar.

Methods: A total of 150 patients with non-dialysis chronic kidney disease attending the clinics at a tertiary hospital in Myanmar participated in this cross-sectional, correlational predictive study. They were recruited by a convenience sampling method. Data were collected by using Sodium Consumption Behavior Questionnaire, Family-Friends Support Subscale and Doctor-Health Care Team Support Subscale of Chronic Illness Resources Survey, demographic and clinical characteristics data form, and by measuring blood pressure against the target level of less than 130/80 mmHg. Descriptive statistics, Chi-square, Fisher’s exact test, and binary logistic regression analysis were performed.

Results: Only 44% of the participants had their blood pressure controlled. Overweight (OR=0.170, 95% CI: 0.058-0.495), obese (OR=0.071, 95% CI: 0.017-0.305), and chronic kidney disease stage 5 (OR=0.070, 95% CI: 0.020-0.244)  were the determinants associated with poorly controlled blood pressure. Low sodium consumption behavior (OR=9.065, 95% CI: 3.251-25.277) and high family support (OR=7.799, 95% CI: 2.738-22.215) were the determinants associated with well-controlled blood pressure.

Conclusion: The blood pressure control rate in Myanmar patients with non-dialysis chronic kidney disease was suboptimal. Determinant findings serve as an input to endorse family-based lifestyle modification interventions such as weight control and low sodium dietary for optimizing blood pressure control. Further investigation of other determinants and of lifestyle intervention programs is warranted.
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Keywords: Blood pressure control; chronic kidney disease; determinants; Myanmar

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  1. Abegaz, T. M., Abdela, O. A., Bhagavathula, A. S., & Teni, F. S. (2018). Magnitude and determinants of uncontrolled blood pressure among hypertensive patients in Ethiopia: Hospital-based observational study. Pharmacy Practice (Granada), 16(2), 1-7. https://doi.org/10.18549%2FPharmPract.2018.02.1173
  2. Ahlawat, R., Tiwari, P., & D'Cruz, S. (2018). Prevalence of depression and its associated factors among patients of chronic kidney disease in a public tertiary care hospital in India: A cross-sectional study. Saudi Journal of Kidney Diseases and Transplantation, 29(5), 1165-1173. https://doi.org/10.4103/1319-2442.243972
  3. Almutary, H., Bonner, A., & Douglas, C. (2016). Which patients with chronic kidney disease have the greatest symptom burden? A comparative study of advanced CKD stage and dialysis modality. Journal of Renal Care, 42(2), 73-82. https://doi.org/10.1111/jorc.12152
  4. Back, I. R., Oliveira, R. R., Silva, E. S., & Marcon, S. S. (2018). Risk factors associated with overweight and obesity in Japanese-Brazilians. Journal of Nutrition and Metabolism, 2018, 5756726. https://doi.org/10.1155/2018/5756726
  5. Banasik, J. (2016). Study guide for pathophysiology (6th ed.). Elsevier
  6. Cheung, A. K., Rahman, M., Reboussin, D. M., Craven, T. E., Greene, T., Kimmel, P. L., Cushman, W. C., Hawfield, A. T., Johnson, K. C., Lewis, C. E., Oparil, S., Rocco, M. V., Sink, K. M., Whelton, P. K., Wright, J. T., Basile, J., Beddhu, S., Bhatt, U., Chang, T. I., Chertow, G. M., . . . Yee, J. (2017). Effects of intensive BP control in CKD. Journal of the American Society of Nephrology, 28(9), 2812–2823. https://doi.org/10.1681/ASN.2017020148
  7. Cho, H., Kim, S. M., Jeong, S. B., & Kim, S. B. (2016). Comparison of salt taste thresholds and salt usage behaviors between adults in Myanmar and Korea. Asia Pacific Journal of Clinical Nutrition, 25(4), 879-884. https://doi.org/10.6133/apjcn.092015.32
  8. Dąbrowska-Bender, M., Dykowska, G., Żuk, W., Milewska, M., & Staniszewska, A. (2018). The impact on quality of life of dialysis patients with renal insufficiency. Patient Preference and Adherence, 12, 577-583. https://doi.org/10.2147/PPA.S156356
  9. DeMarco, V. G., Aroor, A. R., & Sowers, J. R. (2014). The pathophysiology of hypertension in patients with obesity. Nature Reviews. Endocrinology, 10(6), 364–376. https://doi.org/10.1038/nrendo.2014.44
  10. Frazier, L. (2000). Factors influencing blood pressure: Development of a risk model. Journal of Cardiovascular Nursing, 15(1), 62-79. https://doi.org/10.1097/00005082-200010000-00007
  11. GBD Chronic Kidney Disease Collaboration (2020). Global, regional, and national burden of chronic kidney disease, 1990-2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet (London, England), 395(10225), 709–733. https://doi.org/10.1016/S0140-6736(20)30045-3
  12. Glasgow, R. E., Strycker, L. A., Toobert, D. J., & Eakin, E. (2000). A social–ecologic approach to assessing support for disease self-management: The chronic illness resources survey. Journal of Behavioral Medicine, 23(6), 559-583. https://doi.org/10.1023/a:1005507603901
  13. Hill, P. L., Weston, S. J., & Jackson, J. J. (2014). Connecting social environment variables to the onset of major specific health outcomes [Abstract]. Psychology & Health, 29(7), 753-767. https://doi.org/10.1080/08870446.2014.884221
  14. Hossain, F. B., Adhikary, G., Chowdhury, A. B., & Shawon, M. S. R. (2019). Association between body mass index (BMI) and hypertension in South Asian population: Evidence from nationally-representative surveys. Clinical Hypertension, 25(1), 1-9. https://doi.org/10.1186/s40885-019-0134-8
  15. Humalda, J. K., & Navis, G. (2014). Dietary sodium restriction: A neglected therapeutic opportunity in chronic kidney disease. Current Opinion in Nephrology and Hypertension, 23(6), 533–540. https://doi.org/10.1097/MNH.0000000000000073
  16. Hyodo, T., Fukagawa, M., Hirawa, N., Isaka, Y., Nakamoto, H., Van Bui, P., Thwin, K. T., & Hy, C. (2020). Present status of renal replacement therapy in Asian countries as of 2017: Vietnam, Myanmar, and Cambodia. Renal Replacement Therapy, 6(1), 1-14. https://doi.org/10.1186/s41100-020-00312-w
  17. Khadoura, K., Shakibazadeh, E., Mansournia, M. A., Aljeesh, Y., & Fotouhi, A. (2021). Determining the prevalence of and the factors associated with antihypertensive medication non-adherence in the Gaza Strip. Korean Journal of Family Medicine, 42(2), 150–158. https://doi.org/10.4082/kjfm.19.0081
  18. Kuryata, O., Yaschenko, T., & Semenov, V. (2019). Analysis of blood pressure control in outpatients with non-dialysis chronic kidney disease referred by primary care physicians: A study from the centre of nephrology care. Arterial Hypertension, 23(2), 88-97. https://doi.org/10.5603/AH.a2019.0004
  19. Kusuma, H., Ropyanto, C. B., Widyaningsih, S., & Sujianto, U. (2018). Relating factors of insomnia among haemodialysis patients. Nurse Media Journal of Nursing, 8(1), 44-57. https://doi.org/10.14710/nmjn.v8i1.15741
  20. Lee, S., Oh, H. J., Lee, E. K., Lee, O., Ha, E., Kim, S. J., Kang, D. H., Choi, K. B., & Ryu, D. R. (2017). Blood pressure control during chronic kidney disease progression. American Journal of Hypertension, 30(6), 610-616. https://doi.org/10.1093/ajh/hpx017
  21. Lee, Y. B., Lee, J. S., Hong, S. H., Kim, J. A., Roh, E., Yoo, H. J., Baik, S. H., & Choi, K. M. (2021). Optimal blood pressure for patients with chronic kidney disease: A nationwide population-based cohort study. Scientific Reports, 11(1), 1538. https://doi.org/10.1038/s41598-021-81328-y
  22. Lv, J., Ehteshami, P., Sarnak, M. J., Tighiouart, H., Jun, M., Ninomiya, T., Foote, C., Rodgers, A., Zhang, H., Wang, H., Strippoli, G. F., & Perkovic, V. (2013). Effects of intensive blood pressure lowering on the progression of chronic kidney disease: A systematic review and meta-analysis. Canadian Medical Association Journal, 185(11), 949–957. https://doi.org/10.1503/cmaj.121468
  23. Maneesriwongul, W., & Dixon, J. K. (2004). Instrument translation process: A methods review. Journal of Advanced Nursing, 48(2), 175-186. https://doi.org/10.1111/j.1365-2648.2004.03185.x
  24. Meuleman, Y., Hoekstra, T., Dekker, F. W., Navis, G., Vogt, L., van der Boog, P., Bos, W., van Montfrans, G. A., & van Dijk, S. (2017). Sodium restriction in patients with CKD: A randomized controlled trial of self-management support. American Journal of Kidney Diseases, 69(5), 576–586. https://doi.org/10.1053/j.ajkd.2016.08.042
  25. Ojo, O. S., Malomo, S. O., & Sogunle, P. T. (2016). Blood pressure (BP) control and perceived family support in patients with essential hypertension seen at a primary care clinic in Western Nigeria. Journal of Family Medicine and Primary Care, 5(3), 569-575. https://doi.org/10.4103/2249-4863.197284
  26. Piaseu, N., Boonsiri, C., Panichkul, K., Maruo, S. J., Putwatana, P., & Kantachuvesiri, S. (2020). Effects of program promoting food consumption for sodium reduction on knowledge, sodium consumption behaviors, and urinary sodium in nursing students: A multi-setting study. Bangkok Medical Journal, 16(1), 1-6. https://doi.org/10.31524/bkkmedj.2020.11.009
  27. Schneider, M. P., Hilgers, K. F., Schmid, M., Hubner, S., Nadal, J., Seitz, D., Busch, M., Haller, H., Kottgen, A., Kronenberg, F., Baid-Agrawal, S., Schlieper, G., Schultheiss, U., Sitter, T., Sommerer, C., Titze, S., Meiselbach, H., Wanner, C., & Eckardt, K. U. (2018). Blood pressure control in chronic kidney disease: A cross-sectional analysis from the German Chronic Kidney Disease (GCKD) study. PLoS One, 13(8), 1-17. https://doi.org/10.1371/journal.pone.0202604
  28. Than, K. M. M. (2018). RRT-M-Renal replacement therapy in Myanmar, a developing country [Abstract]. Journal of Nephrology and Therapeutics, 8, 16. https://doi.org/10.4172/2161-0959-C4-060
  29. Thike, T. Z., Saw, Y. M., Lin, H., Chit, K., Tun, A. B., Htet, H., Cho, S. M., Khine, A. T., Saw, T. N., Kariya, T., Yamamoto, E., & Hamajima, N. (2020). Association between body mass index and ready-to-eat food consumption among sedentary staff in Nay Pyi Taw Union Territory, Myanmar. BioMed Central Public Health, 20(1), 1-10. https://doi.org/10.1186/s12889-020-8308-6
  30. Wang, L. Y., Yin, D. X., Zhang, D. L., Xu, R., Cui, W. Y., & Liu, W. H. (2013). Improvement and influencing factors of blood pressure control by nephrologist referral in chronic kidney disease patients in China: A cohort study. International Urology and Nephrology, 45(5), 1345-1353. https://doi.org/10.1007/s11255-012-0332-8
  31. Whelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Collins, K. J., Himmelfarb, C. D., Depalma, S. M., Gidding, S., Jamerson, K. A., Jones, D. W., Maclaughlin, E. J., Muntner, P., Ovbiagele, B., Smith, S. C., Spencer, C. C., Stafford, R. S., Taler, S. J., Thomas, R. J., Williams, K. A., . . . Wright, J. T. (2018). 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/ APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension, 71(6), e13-e115. https://doi.org/10.1161/HYP.0000000000000065
  32. World Health Organization. (2020). Noncommunicable diseases: Progress monitor 2020
  33. World Health Organization Expert Consultation. (2004). Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet, 363(9403), 157–163. https://doi.org/10.1016/s0140-6736(03)15268-3
  34. Xie, Y., Bowe, B., Mokdad, A. H., Xian, H., Yan, Y., Li, T., Maddukuri, G., Tsai, C., Floyd, T., & Al-Aly, Z. (2018). Analysis of the global burden of disease study highlights the global, regional, and national trends of chronic kidney disease epidemiology from 1990 to 2016. Kidney International, 94(3), 567-581. https://doi.org/10.1016/j.kint.2018.04.011
  35. Yan, Z., Wang, Y., Li, S., Wang, J., Zhang, L., Tan, H., Li, S., Yang, L., Pei, H., Zhang, L., Wang, Y., Duan, J., Jiao, S., Zhao, M., & Fu, S. (2018). Hypertension control in adults with CKD in China: Baseline results from the Chinese cohort study of chronic kidney disease (C-STRIDE). American Journal of Hypertension, 31(4), 486-494. https://doi.org/10.1093/ajh/hpx222
  36. Zhang, J., Healy, H. G., Venuthurupalli, S. K., Tan, K. S., Wang, Z., Cameron, A., & Hoy, W. E. (2019). Blood pressure management in hypertensive people with non-dialysis chronic kidney disease in Queensland, Australia. BioMed Central Nephrology, 20(1), 1-10. https://doi.org/10.1186/s12882-019-1532-6
  37. Zheng, Y., Tang, L., Zhang, W., Zhao, D., Zhang, D., Zhang, L., Cai, G., & Chen, X. (2020). Applying the new intensive blood pressure categories to a nondialysis chronic kidney disease population: The prevalence, awareness and treatment rates in chronic kidney disease patients with hypertension in China survey. Nephrology Dialysis Transplantation, 35(1), 155-161. https://doi.org/10.1093/ndt/gfy301

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