Blood Pressure Parameters and their Associations with Death in Patients with Chronic Kidney Disease

Area of Science:

• Nephrology
• Cardiology
• Geriatrics

Background:

• Blood pressure (BP) management in chronic kidney disease (CKD) remains a complex issue.
• Observational studies suggest a U- or J-shaped relationship between BP and mortality in CKD patients.
• Specific BP ranges (<110 mmHg and >150 mmHg systolic BP) are linked to increased mortality in CKD.

Purpose of the Study:

• To critically review recent literature on BP parameters and mortality in non-dialysis-dependent CKD.
• To define optimal BP targets for patients with CKD.
• To evaluate the impact of BP control on patient-centered outcomes in CKD.

Main Methods:

• Systematic review of recent literature.
• Analysis of observational studies and randomized controlled trials (RCTs).
• Evaluation of data from the SPRINT trial.

Main Results:

• Observational data indicate a U- or J-shaped association between BP and mortality in CKD.
• The SPRINT trial suggests intensive BP control (<120 mmHg systolic BP) reduces cardiovascular events and mortality in non-diabetic individuals, including those with CKD.
• Evidence supports lower BP targets for non-diabetic CKD, but further trials are needed for diabetic CKD and individualized approaches for the elderly.

Conclusions:

• Intensive BP control may benefit non-diabetic CKD patients.
• Individualized BP targets are necessary for elderly CKD patients.
• Further research is required to establish optimal BP targets for diabetic CKD patients.