In a real-world cohort of patients with chronic kidney disease, only 10.3% had controlled blood pressure, with poorer control significantly associated with more advanced CKD stages (p=0.049).
Observational (n=448)
Blood pressure control in real-world CKD patients is poor (10.3%) and worsens with more advanced CKD stages, highlighting the need for individualized, multifactorial management.
p-value: p=0.049
Objective: Blood pressure (BP) control in patients with chronic kidney disease (CKD) remains challenging despite the use of guideline-recommended therapies. This study aimed to use real-world data from nephrology outpatient clinic (NOC) visits to identify determinants of BP control and short-term BP dynamics beyond pharmacological treatment. Design and method: We analysed data from 448 first NOC visits and 193 follow-up visits conducted 3 to 6 months later. Mean home BP monitoring (HBPM), laboratory parameters, CKD stage, and use of nephroprotective therapies (ACEi/ARBs, SGLT2i, GLP-1 receptor agonists, MRAs) were recorded. Controlled BP was defined as BP<130/80 mmHg. Statistical analyses were performed using SPSS® version 31.0 (IBM Corp., Chicago, IL, USA). Results: Of the 448 included patients, 54.5% were male, with a mean age of 68.0±15.9 years. Forty-six patients (10.3%) presented with controlled BP at the first visit, while CKD stage 3 was the most prevalent diagnosis (54.6%). CKD stage was significantly associated with BP control (χ2 = 7.785, p = 0.049), with more advanced stages showing poorer BP control. At the first visit, mean serum sodium levels differed significantly between patients with controlled and uncontrolled BP (137±4 vs. 140±3, t(291) = 2.371, p = 0.019). At follow-up, significant differences between patients with controlled and uncontrolled BP were observed for serum phosphate (1.26±0.62 vs. 1.12±0.21, t(162) = -1.896, p = 0.032) and serum ferritin levels (241±174 vs. 136±178, t(164) = -2.322, p = 0.021). No significant differences were observed for other laboratory parameters. Patients who presented with lower BP values at follow-up had a smaller decline in eGFR between visits (B = -0.42, p = 0.022). CKD stage and the number of nephroprotective drug classes showed no statistical correlation with the change in systolic BP between visits. Conclusions: BP control in patients with CKD remains suboptimal in real-world nephrology practice and is strongly influenced by CKD stage. Our findings highlight that effective BP management in CKD extends beyond the choice of antihypertensive and nephroprotective drugs and requires an individualised, multifactorial approach.
Vreča et al. (Fri,) conducted a observational in chronic kidney disease (n=448). CKD stage and laboratory parameters was evaluated on Blood pressure control (BP < 130/80 mmHg) (p=0.049). In a real-world cohort of patients with chronic kidney disease, only 10.3% had controlled blood pressure, with poorer control significantly associated with more advanced CKD stages (p=0.049).