Background/ introduction

Hypertension is very prevalent among patient with end stage renal disease (ESRD) treated with
hemodialysis and often poorly controlled. As is for general population, hypertension is one of the major
causes of cardiovascular mortality for patients who take dialysis. Patients who remains hypertension
after management is challenging, and there are many unsolved problems. However, many variety of
other non-pharmacologic treatment have been developed as alternative approaches for lowering blood
pressure. Mirroring the AHA scientific statement, zikir is classed into behavioral therapies. Zikir is a
mind-body practice in Islam.

There are several theory and hypothesis about the pathogenesis of hypertension and about how blood
pressure is affected by mind-body practice intervention, Zikir could make patients relax. According to
previous study, this condition makes slower breathing, reduces sympathetic activity and increase
baroreceptor sensitivity, increase heart rate variability, indicate and increase parasympathetic activity.
Zikir also utilize to affect reducing level of cortisol, but the mechanism still unknown, it is suggested that
it might be through inhibition of the vasodilator nitric oxide system and through increasing
vasoconstrictor erithopoetin concentration.

The present study was design to evaluate the effectiveness of Zikir’s on blood pressure among
hypertensive hemodialysis patient at hemodialysis room at Hasan Basry Hospital “Peduli Ibadah”

Materials and methods

Study design

We conducted a prospective, randomized, open labelled, blinded end evaluation, trial/study with follow
up after 12 weeks intervention completion. After 3 weeks or 21 days intervention, we plan to ?????
analysis. A sample calculation we had assumed a 5 mmHg between a different group in systolic blood
pressure, to allow 80% power to detect as significant as the 5% level, allowing 5% dropout (two sided
test) we determined that………………… patients were required (….. per group)

The study design and procedures were approved by the regional ethical review board in Lambung
Mangkurat University, Faculty of Medicine.

Participant and recruitment

Patient ESRD at Hemodialysis Unit at Hasan Basry Hospital, aged…. with comorbid hypertension
identified or diagnosed according to the 2004 National kidney foundation kidney disease outcome
quality initiative guideline, hypertension in haemodialysis patient is diagnosed with blood pressure
before (>140/90 mmHg) and after (>130/80) dialysis. Participant were invited to