August 11, 2011BMC NephrologyOpen Access

Association of blood pressure with decline in renal function and time until the start of renal replacement therapy in pre-dialysis patients: a cohort study

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Why the study?

Does high blood pressure accelerate renal function decline and time to renal replacement therapy in pre-dialysis patients with CKD stages IV-V?

Population

508 incident pre-dialysis patients with advanced chronic kidney disease, median age 63, 57% men, from eight…

Comparison

Systolic and diastolic blood pressure above the… vs Systolic and diastolic blood pressure below the…

Design

Cohort

Follow-up

median 351 days (first year of pre-dialysis care)

Authors

MGMoniek CM de GoeijLeiden University Medical Center NVNora VoormolenLeiden University Medical Center NHNynke HalbesmaUniversity of Edinburgh

Discussion

Member takes

Implication

May inform BP targets in advanced pre-dialysis CKD; extends observational links but leaves open causal confirmation by RCTs.

Structured PICO

Does high blood pressure accelerate renal function decline and time to renal replacement therapy in pre-dialysis patients with CKD stages IV-V?

Population

508 incident pre-dialysis patients with advanced chronic kidney disease (CKD stages IV-V), median age 63, 57% men, from eight Dutch hospitals. Key inclusion: creatinine clearance <20 ml/min, expected need for renal replacement therapy within one year.

Intervention

Systolic and diastolic blood pressure above the target goal of < 130/80 mmHg (exposure)

Comparator

Systolic and diastolic blood pressure below the target goal of < 130/80 mmHg

Outcome

Rate of decline in renal function (estimated as the slope of available eGFR measurements) and time until the start of renal replacement therapy (RRT) during the first year of pre-dialysis carehard clinical

In pre-dialysis patients with advanced CKD, having a systolic blood pressure above 130 mmHg is associated with a faster decline in renal function and an earlier need for renal replacement therapy.

Limitations

Blood pressure was only assessed at baseline and levels can change during pre-dialysis care
Data regarding proteinuria, hemoglobin, and baseline eGFR were not available for all patients

Cite This Study

Goeij et al. (2011) studied this question.

synapsesocial.com/papers/6a8a4a99273d243e4992f905 https://doi.org/10.1186/1471-2369-12-38

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Association of blood pressure with decline in renal function and time until the start of renal replacement therapy in pre-dialysis patients: a cohort study

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Association of blood pressure with decline in renal function and time until the start of renal replacement therapy in pre-dialysis patients: a cohort study

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Also Consider

Also Consider