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Updated: May 29, 2026
Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Relationship between blood pressure and incident chronic kidney disease in hypertensive patients
Rebecca Hanratty1, Michel Chonchol, Edward P Havranek
1Denver Health, Denver, CO 80204, USA. Rebecca.hanratty@dhha.org
Insights
Hypertension and diabetes are key risk factors for chronic kidney disease (CKD) progression. Maintaining systolic blood pressure below 120 mmHg is crucial for hypertensive patients to prevent CKD.
Area of Science:
- Nephrology
- Cardiology
- Epidemiology
Background:
- Hypertension is a leading cause of chronic kidney disease (CKD).
- Identifying risk factors for CKD progression in hypertensive patients is crucial for targeted therapies.
- Early intervention can help slow or prevent kidney function decline.
Purpose of the Study:
- To identify risk factors for the development of incident CKD.
- To determine factors associated with a decline in estimated glomerular filtration rate (eGFR) in hypertensive patients.
Main Methods:
- Cox proportional hazards models were employed.
- Analysis of a registry of hypertensive patients.
- Incident CKD defined as eGFR <60 ml/min per 1.73 m(2).
Main Results:
- Diabetes was the strongest predictor of incident CKD (HR, 1.96).
- Systolic blood pressure (BP) above 120 mmHg increased CKD risk.
- Each 10-mmHg increase in systolic BP raised CKD risk by 6% and accelerated eGFR decline.
Conclusions:
- Time-varying systolic BP is associated with incident CKD in hypertensive individuals.
- Elevated systolic BP (>120 mmHg) significantly increases CKD risk.
- Managing BP is critical for preserving kidney function in hypertension.
Background And Objectives:
Hypertension is an important cause of chronic kidney disease (CKD). Identifying risk factors for progression to CKD in patients with normal kidney function and hypertension may help target therapies to slow or prevent decline of kidney function. Our objective was to identify risk factors for development of incident CKD and decline in estimated GFR (eGFR) in hypertensive patients.
Design, Setting, Participants, & Measurements:
Cox proportional hazards models were used to assess the relationship between incident CKD (defined as eGFR <60 ml/min per 1.73 m(2)) and potential risk factors for CKD from a registry of hypertensive patients.
Results:
Of 43,305 patients meeting the inclusion criteria, 12.1% (5236 patients) developed incident CKD. Diabetes was the strongest predictor of incident CKD (hazard ratio, 1.96; 95% confidence interval, 1.84 to 2.09) and was associated with the greatest rate of decline in eGFR (-2.2 ml/min per 1.73 m(2) per year). Time-varying systolic BP was associated with incident CKD with risk increasing above 120 mmHg; each 10-mmHg increase in baseline and time-varying systolic BP was associated with a 6% increase in the risk of developing CKD (hazard ratio, 1.06; 95% confidence interval, 1.04 to 1.08 for both). Time-weighted systolic BP was associated with a more rapid decline in eGFR of an additional 0.2 ml/min per 1.73 m(2) per year decline for every 10-mmHg increase in systolic BP.
Conclusions:
We found that time-varying systolic BP was associated with incident CKD, with an increase in risk above a systolic BP of 120 mmHg among individuals with hypertension.
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