Monitoring of Renin-angiotensin-aldosterone-system (RAAS) Inhibitors and Diuretics Applied in General Hospital-Ikot Ekpene and St. Luke’s Hospital-Uyo of Akwa Ibom State, Nigeria

Abstract

Introduction: Blockade of renin-angiotensin-aldosterone system (RAAS) has been shown to be beneficial in patients with hypertension, acute myocardial infarction, chronic heart failure and diabetic renal disease. However, RAAS inhibitors and diuretic therapy are associated with some side effects, notably electrolytes imbalance and renal impairment. Objective: This study was aimed at assessing the extent of monitoring of renal function and electrolyte levels in cardiovascular disease patients managed with RAAS inhibitors and diuretics. Methods: The study was carried out in two selected secondary health facilities (General Hospital-Ikot Ekpene and St Luke’s Hospital-Uyo) in Akwa Ibom State, Nigeria between May and September 2016. The case notes of 600 (300 from each facility) cardiovascular disease patients managed with RAAS inhibitors and diuretics were retrieved from the hospital medical record of the study centers and reviewed. Relevant information was collected. Data obtained were analyzed using statistical program for social science (SPSS) version 17 with descriptive statistics. Results: Of the 600 case notes studied, only 2.8% of the cases had a baseline monitoring of renal function and electrolyte concentrations. Only 2.2% of the cases had a follow-up monitoring (without baseline monitoring) of renal function and electrolyte concentrations. None of the cases studied had both baselines and followed up monitoring of renal function and electrolyte levels. Conclusion: Non-adherence to guidelines on renal function and electrolytes monitoring was observed amongst the cases studied. The prescribers should be educated on the risks associated with lack of proper monitoring of renal function and electrolyte levels in cardiovascular disease patients managed with RAAS inhibitors and diuretics.