Key result
SBP ≥140 mmHg linked to ~63% higher incident CKD risk versus 120-129 mmHg.
Why the study?
The study investigated the association between systolic blood pressure and incident chronic kidney disease risk using a marginal structural model to account for mutual effects of exposure and confounders.
Does higher systolic blood pressure increase the risk of incident chronic kidney disease in adults with preserved renal function?
Cohort (n=195,970)
Does higher systolic blood pressure increase the risk of incident chronic kidney disease in adults with preserved renal function?
Effect estimate: HR 1.63 (95% CI 1.47-1.80)
Absolute Event Rate: 3.1% vs 1.5%
p-value: p=<0.001
Higher systolic blood pressure is significantly associated with an increased risk of incident chronic kidney disease in adults with preserved renal function.
Elevated SBP was associated with higher incident CKD risk; leaves open optimal targets for prevention in preserved renal function.
BACKGROUND: We aimed to investigate the association between systolic blood pressure (SBP) and risk of incident chronic kidney disease (CKD) using marginal structural model (MSM) to reflect mutual effects of exposure and confounders on the outcome. METHODS: A total of 195,970 adults with an estimated glomerular filtration rate (eGFR) of >60 mL/min/1.73 m2 and no proteinuria were included from a nationally representative sample cohort of Korean population. SBPs were measured through national health examinations. Primary outcome was incident CKD, defined as a composite of events of a decrease in eGFR to <60 mL/min/1.73 m2 or a newly developed proteinuria for at least two consecutive measurements. The association between SBP and risk of CKD was examined using Cox model, time-dependent Cox model, and MSM. RESULTS: During a follow-up of 5 years, CKD occurred in 3,355 participants (1.7%). With SBP treated as a continuous variable, each 10-mmHg increment was associated with higher risk for incident CKD, regardless of analytical models used. Compared to SBP group of 120-129 mmHg, hazard ratios (95% confidence intervals) for incident CKD for SBP groups of <110, 110-119, 130-139, and ≥140 mmHg in MSM were 0.70 (0.62-0.80), 0.85 (0.77-0.95), 1.16 (1.05-1.27), and 1.63 (1.47-1.80), respectively. CONCLUSION: In this nationwide study, we found a significant relationship between higher SBP and higher risk of incident CKD. Further studies are warranted to verify the potential significance of high SBP as a preventable risk factor for the development of CKD in those with preserved renal function.
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Lim et al. (2023) conducted a cohort in Incident chronic kidney disease (n=195,970). Systolic blood pressure ≥140 mmHg vs. Systolic blood pressure 120-129 mmHg was evaluated on Incident chronic kidney disease (composite of eGFR <60 mL/min/1.73 m2 or newly developed proteinuria) (HR 1.63, 95% CI 1.47-1.80, p=<0.001). A systolic blood pressure of ≥140 mmHg was associated with a significantly higher risk of incident chronic kidney disease (HR 1.63) compared to a systolic blood pressure of 120-129 mmHg.
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