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Assessment of Vascular Function in Patients With Chronic Kidney Disease
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Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

Pulse pressure and progression of chronic kidney disease

Nishkanta Arulkumaran1, Ramaswamy Diwakar, Zaheer Tahir

  • 1Renal and Transplantation Unit, St. George's Hospital NHS Trust, Tooting, London - UK.

Journal of Nephrology
|February 2, 2010
PubMed

Insights

Pulse pressure (PP) predicts adverse outcomes in chronic kidney disease (CKD). Higher baseline PP is linked to declining kidney function in mild to moderate CKD, suggesting it

Area of Science:

  • Nephrology
  • Cardiovascular Medicine

Background:

  • Pulse pressure (PP) is a known predictor of adverse outcomes in patients undergoing hemodialysis and those with predialysis chronic kidney disease (CKD).
  • The association between PP and kidney disease progression in mild to moderate CKD remains unclear.

Purpose of the Study:

  • To investigate the relationship between pulse pressure (PP) and kidney disease progression in patients with mild to moderate CKD.
  • To determine if PP is a better predictor of adverse renal outcomes than systolic blood pressure (SBP) or diastolic blood pressure (DBP) in this population.

Main Methods:

  • A cohort of 329 CKD patients was followed for approximately 172 days.
  • Baseline clinical characteristics, including estimated glomerular filtration rate (eGFR), SBP, DBP, and PP, were recorded.
  • Changes in eGFR, SBP, DBP, and PP were monitored during the follow-up period.

Main Results:

  • Declining kidney function (eGFR) was inversely related to baseline SBP and PP, but not DBP.
  • Higher baseline PP was associated with a greater decline in eGFR during follow-up.
  • Patients with declining eGFR had significantly higher baseline PP and SBP compared to those with stable eGFR.

Conclusions:

  • Baseline pulse pressure (PP) emerged as the sole predictor of eGFR decline, independent of other clinical factors.
  • A PP greater than 65 mm Hg was associated with declining renal function.
  • PP is a more potent predictor of adverse renal outcomes in mild to moderate CKD than DBP or SBP.
Abstract

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