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
2011

Blood Pressure and Kidney Function in Pre-Dialysis Patients

Sample size: 508 publication 10 minutes Evidence: moderate

Author Information

Author(s): Moniek CM de Goeij, Nora Voormolen, Nynke Halbesma, Dinanda J de Jager, Elisabeth W Boeschoten, Yvo WJ Sijpkens, Friedo W Dekker, Diana C Grootendorst

Primary Institution: Leiden University Medical Center

Hypothesis

Does high blood pressure accelerate renal function decline in patients with advanced chronic kidney disease?

Conclusion

High blood pressure, especially systolic blood pressure, is linked to a faster decline in kidney function and an earlier start of renal replacement therapy in pre-dialysis patients.

Supporting Evidence

  • Every 10 mmHg increase in systolic blood pressure led to a 0.04 ml/min/1.73 m2/month faster decline in renal function.
  • Patients with systolic blood pressure above 130 mmHg had a 2.08 times higher risk of starting renal replacement therapy.
  • 89% of patients did not reach the blood pressure target goal of < 130/80 mmHg.

Takeaway

If you have high blood pressure, your kidneys might not work as well, and you could need dialysis sooner.

Methodology

The study followed 547 pre-dialysis patients from eight Dutch hospitals, measuring blood pressure and renal function over time.

Potential Biases

Potential residual confounding due to unmeasured variables affecting kidney function.

Limitations

The study only measured blood pressure once at the start of pre-dialysis care, which may not reflect changes over time.

Participant Demographics

57% men, median age 63 years, predominantly Caucasian.

Statistical Information

P-Value

0.04

Confidence Interval

(0.02;0.07)

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1186/1471-2369-12-38

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