Why the study?
KDIGO guidelines suggest more intensive BP control with systolic BP <120 mmHg in DKD, but an extremely low BP level may paradoxically worsen renal function and cardiovascular outcomes.
Does optimal blood pressure control using medications improve cardiovascular and renal outcomes in patients with diabetic kidney disease?
Does optimal blood pressure control using medications improve cardiovascular and renal outcomes in patients with diabetic kidney disease?
This review examines the literature on optimal blood pressure targets in diabetic kidney disease, highlighting the balance between cardiovascular benefits and potential renal risks of intensive control.
Supports intensive SBP targets in DKD per KDIGO; leaves open optimal kidney outcomes pending dedicated trials.
Diabetic kidney disease (DKD) is the most common cause of end-stage kidney disease. Blood pressure (BP) control can reduce the risks of cardiovascular (CV) morbidity, mortality, and kidney disease progression. Recently, the Kidney Disease: Improving Global Outcomes (KDIGO) guidelines have suggested the implementation of a more intensive BP control with a target systolic BP (SBP) of <120 mmHg based on the evidence that the CV benefits obtained is outweighed by the kidney injury risk associated with a lower BP target. However, an extremely low BP level may paradoxically aggravate renal function and CV outcomes. Herein, we aimed to review the existing literature regarding optimal BP control using medications for DKD.
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Kim et al. (2022) studied this question.
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