Related Experiment Video

Updated: May 8, 2026

Assessment of Vascular Function in Patients With Chronic Kidney Disease
08:50

Assessment of Vascular Function in Patients With Chronic Kidney Disease

Published on: June 16, 2014

Blood pressure and mortality in U.S. veterans with chronic kidney disease: a cohort study

Csaba P Kovesdy, Anthony J Bleyer, Miklos Z Molnar

    Annals of Internal Medicine
    |September 13, 2013
    PubMed

    Insights

    The ideal blood pressure (BP) for patients with chronic kidney disease (CKD) appears to be 130-159/70-89 mm Hg. Achieving lower diastolic BP may increase mortality risk in CKD patients.

    Area of Science:

    • Nephrology
    • Cardiovascular Medicine
    • Epidemiology

    Background:

    • The optimal blood pressure (BP) target for reducing mortality in non-dialysis-dependent chronic kidney disease (CKD) patients remains uncertain.
    • Understanding BP associations with mortality is crucial for managing CKD patients.

    Purpose of the Study:

    • To investigate the relationship between combined systolic BP (SBP) and diastolic BP (DBP) levels and all-cause mortality in a large cohort of US veterans with CKD.

    Main Methods:

    • A historical cohort study was conducted from 2005-2012, including 651,749 US veterans with CKD.
    • BP was categorized into 96 combinations of SBP and DBP.
    • Time-dependent Cox models were used to analyze associations with all-cause mortality, adjusting for confounders.

    Main Results:

    • The lowest adjusted mortality rates were observed in patients with SBP of 130-159 mm Hg and DBP of 70-89 mm Hg.
    • Conversely, very high or very low SBP and DBP were associated with the highest mortality rates.
    • Moderately elevated SBP with DBP ≥70 mm Hg showed lower mortality than ideal SBP with DBP <70 mm Hg.

    Conclusions:

    • The optimal BP range for CKD patients is suggested to be 130-159/70-89 mm Hg.
    • Prioritizing ideal SBP at the cost of suboptimal DBP may not be beneficial for mortality outcomes in CKD.
    • Study limitations include a predominantly male cohort, missing proteinuria data, and inability to establish causality.
    Abstract

    Related Concept Videos

    Chronic Kidney Disease I: Introduction01:25

    Chronic Kidney Disease I: Introduction

    Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
    Chronic Kidney Disease IV: Nursing Management01:18

    Chronic Kidney Disease IV: Nursing Management

    Nursing management is essential for preventing complications, maintaining stability, and improving patients' quality of life in chronic kidney disease (CKD). By using a structured approach, nurses help slow CKD progression and support effective patient care​.1. Comprehensive patient assessmentEffective management begins with nurses reviewing the patient’s medical history, and identifying key risk factors like diabetes, hypertension, and nephrotoxic drug use. Nurses assess signs of fluid...
    Chronic Kidney Disease II: Clinical Manifestations01:24

    Chronic Kidney Disease II: Clinical Manifestations

    Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
    Chronic Kidney Disease III: Interprofessional Care01:28

    Chronic Kidney Disease III: Interprofessional Care

    Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
    Hypertension and Regulation of Blood Pressure01:18

    Hypertension and Regulation of Blood Pressure

    Hypertension, the most common cardiovascular disease, is diagnosed through repeated measurements of elevated blood pressure. Its risks, including damage to the kidney, heart, and brain, are directly proportional to blood pressure levels. Starting from 115/75 mm Hg, the risk of cardiovascular disease doubles with each increment of 20/10 mm Hg. The diagnosis relies on blood pressure measurements, not on patient symptoms, as hypertension is often asymptomatic until end-organ damage is imminent or...
    Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

    Acute Kidney Injury IV: Diagnostic Studies and Prevention

    Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...