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Kidney function can improve in patients with hypertensive CKD.

Bo Hu¹, Crystal Gadegbeku, Michael S Lipkowitz

¹Cleveland Clinic, Cleveland, OH 44195, USA. hub@ccf.org

Journal of the American Society of Nephrology : JASN

|March 10, 2012

Summary

Some patients with chronic kidney disease (CKD) can experience improved kidney function. This study found sustained improvement in estimated glomerular filtration rate (eGFR) in 3.3% of participants with hypertensive CKD.

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Assessment of Vascular Function in Patients With Chronic Kidney Disease

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

Area of Science:

Nephrology
Hypertension Research
Clinical Epidemiology

Background:

Chronic kidney disease (CKD) is typically assumed to be progressive.
Methodological challenges like measurement error hinder the documentation of kidney function improvement.

Purpose of the Study:

To determine if some patients with CKD can achieve sustained improvement in glomerular filtration rate (GFR).
To investigate factors associated with kidney function improvement in hypertensive CKD patients.

Main Methods:

Utilized 12-year follow-up data from the African American Study of Kidney Disease and Hypertension.
Calculated estimated GFR (eGFR) from serum creatinine and (125)I-iothalamate measurements.
Employed Bayesian mixed-effects models to identify patients with clearly positive eGFR slopes beyond random variation.

Main Results:

3.3% (31 out of 949) of patients showed clearly positive eGFR slopes, indicating improved kidney function.
The mean eGFR slope among improved patients was +1.06 ml/min/1.73 m²/yr.
Lower baseline proteinuria and randomization to a lower blood pressure goal (≤92 mmHg MAP) were associated with improved eGFR.

Conclusions:

Extended follow-up provides strong evidence that kidney function can improve in some patients with hypertensive CKD.
Identifying patients with potential for kidney function improvement may inform treatment strategies.