Compared with controlled SBP (<130 mmHg), moderate (130-149 mmHg) and poor SBP control increased the risk of ESRD with hazard ratios of 3.87 and 9.09, respectively, in veterans with CKD.
Cohort (n=218)
No
Do systolic and diastolic blood pressure levels predict the risk of end-stage renal disease and all-cause mortality in older patients with chronic kidney disease?
In older patients with chronic kidney disease, higher systolic blood pressure strongly predicts progression to end-stage renal disease, while a J-shaped relationship for systolic BP and an inverse relationship for diastolic BP predict all-cause mortality.
Effect estimate: HR 3.87
BACKGROUND AND OBJECTIVES: Mean arterial pressure has been used in clinical trials in nephrology to randomly assign and treat patients, yet the pulsatile component of BP is recognized to influence outcomes in older people. I examined the unique contributions of systolic (SBP) and diastolic BP (DBP) on the risk for ESRD and death in patients with chronic kidney disease (CKD). DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: A single-center, prospective cohort study was conducted of 218 veterans with CKD (22% black, 4% women, mean age 68 yr, clinic BP 154.1 +/- 25.1/85.2 +/- 13.9 mmHg, 48% with diabetes). RESULTS: During follow-up of up to 7 yr, 63 patients had ESRD and 102 patients died. Compared with those with controlled SBP (65 yr. CONCLUSIONS: In older patients with CKD, SBP predicts ESRD and a higher SBP and lower DBP predicts all-cause mortality. Lower BP of <110/70 mmHg is a marker of higher mortality in older individuals with advanced CKD.
Rajiv Agarwal (2009) conducted a cohort in Chronic kidney disease (CKD) (n=218). Systolic blood pressure (SBP) and diastolic blood pressure (DBP) vs. Controlled SBP (<130 mmHg) was evaluated on End-stage renal disease (ESRD) (HR 3.87). Compared with controlled SBP (<130 mmHg), moderate (130-149 mmHg) and poor SBP control increased the risk of ESRD with hazard ratios of 3.87 and 9.09, respectively, in veterans with CKD.