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SPRINT and the Kidney: What Have We Learned?
Racquel Wells1, Mahboob Rahman2,3
1Department of Medicine, University Hospitals Cleveland Medical Center, Louis Stokes Cleveland VA Medical Center, Case Western Reserve University, 11100 Euclid Ave., Cleveland, OH, 44106, USA.
Current Hypertension Reports
|September 16, 2018
Summary
Intensive blood pressure lowering in the Systolic Blood Pressure Interventional Trial (SPRINT) reduced cardiovascular risks and mortality in patients with chronic kidney disease (CKD). However, it did not improve kidney outcomes and increased acute kidney injury risk.
Area of Science:
- Nephrology
- Cardiology
- Clinical Trials
Background:
- Hypertension is a significant risk factor for cardiovascular and kidney disease.
- Previous studies on intensive blood pressure lowering in chronic kidney disease (CKD) populations yielded unclear benefits.
- The Systolic Blood Pressure Interventional Trial (SPRINT) investigated intensive versus standard blood pressure management.
Purpose of the Study:
- To review the impact of the SPRINT trial on renal function and chronic kidney disease (CKD).
- To evaluate the effects of intensive blood pressure lowering on cardiovascular and kidney outcomes in high-risk patients.
Main Methods:
- The SPRINT trial compared standard (<140 mmHg) and intensive (<120 mmHg) blood pressure management.
- Analysis focused on a subgroup of non-diabetic patients with high cardiovascular disease risk, including those with CKD.
Main Results:
- Intensive blood pressure lowering significantly reduced cardiovascular disease risk and mortality in the CKD subgroup.
- No significant benefit on clinical kidney outcomes was observed, apart from reduced albuminuria.
- The intensive treatment group experienced a higher risk of incident CKD and acute kidney injury, though renal function often recovered.
Conclusions:
- Intensive blood pressure lowering offers clear cardiovascular and mortality benefits for patients with CKD.
- Longer-term follow-up is necessary to fully ascertain the effects on kidney function.
- While beneficial for cardiovascular health, intensive management requires careful monitoring for potential renal adverse events.
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