Mean systolic BP 140-149 mmHg (vs 120-129 mmHg) was associated with a higher hazard of eGFR decline, ESRD, or death in diabetic kidney disease (HR 1.51; 95% CI 1.06-2.15; P=0.02).
Observational (n=1,448)
Do higher mean on-treatment blood pressure levels increase the risk of adverse renal outcomes in patients with proteinuric diabetic kidney disease?
In patients with proteinuric diabetic kidney disease, mean systolic BP ≥ 140 mmHg and mean diastolic BP ≥ 80 mmHg are associated with worse renal outcomes.
Effect estimate: HR 1.51 (95% CI 1.06, 2.15)
p-value: p=0.02
BACKGROUND AND OBJECTIVES: Proteinuric diabetic kidney disease frequently progresses to ESRD. Control of BP delays progression, but the optimal BP to improve outcomes remains unclear. The objective of this analysis was to evaluate the relationship between BP and renal outcomes in proteinuric diabetic kidney disease. DESIGN, SETTING, PARTICIPANTS, P=0.02). There was also a significant association of mean diastolic BP with the hazard of developing the primary end point (P<0.01), with a significantly higher hazard ratio when mean diastolic BP was 80-89 versus 70-79 mmHg (1.54 1.05, 2.25; P=0.03); there was also a strong trend when mean diastolic BP was <60 mmHg. Associations between BP and both renal end point and rate of eGFR decline were similar to those with the primary end point. No association of BP with mortality was observed, possibly because of the limited number of mortality events. CONCLUSIONS: In patients with proteinuric diabetic kidney disease, mean systolic BP ≥ 140 mmHg and mean diastolic BP ≥ 80 mmHg were associated with worse renal outcomes.
Leehey et al. (Tue,) conducted a observational in Proteinuric diabetic kidney disease (n=1,448). Mean on-treatment systolic BP 140-149 mmHg vs. Mean systolic BP 120-129 mmHg was evaluated on Decline in eGFR, ESRD, or death (HR 1.51, 95% CI 1.06, 2.15, p=0.02). Mean systolic BP 140-149 mmHg (vs 120-129 mmHg) was associated with a higher hazard of eGFR decline, ESRD, or death in diabetic kidney disease (HR 1.51; 95% CI 1.06-2.15; P=0.02).