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Updated: Oct 21, 2025

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

16.4K

Association of blood pressure with cardiovascular outcome and mortality: results from the KNOW-CKD study

Jee Young Lee1, Jung Tak Park1, Young Su Joo1

  • 1Department of Internal Medicine, College of Medicine, Institute of Kidney Disease Research, Yonsei University, Seoul, Republic of Korea.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|September 2, 2021
PubMed

Insights

Optimal blood pressure control is crucial for patients with chronic kidney disease (CKD). This study found a U-shaped association between systolic blood pressure (SBP) and adverse outcomes, indicating risks at both low and high SBP levels.

Area of Science:

  • Nephrology
  • Cardiology
  • Clinical Epidemiology

Background:

  • Optimal blood pressure (BP) management is vital for reducing cardiovascular events (CVEs) and mortality in chronic kidney disease (CKD) patients.
  • Understanding the precise BP targets is critical for effective therapeutic strategies in CKD.

Purpose of the Study:

  • To investigate the association between systolic blood pressure (SBP) levels and the risk of adverse cardiovascular outcomes and all-cause mortality in patients with CKD.
  • To identify the optimal SBP range for improving clinical outcomes in the CKD population.

Main Methods:

  • Analysis of 2226 participants from the KoreaN cohort study for Outcome in patients With CKD (KNOW-CKD).
  • Systolic blood pressure (SBP) was categorized into five levels: <110, 110-119, 120-129, 130-139, and ≥140 mmHg.
  • Marginal structural models (MSMs) were employed using averaged and most recent time-updated SBPs to assess the primary endpoint (composite of all-cause death or incident CVEs).

Main Results:

  • A U-shaped relationship was observed between averaged SBP and the primary composite outcome.
  • Compared to SBP of 110-119 mmHg, hazard ratios (95% CI) for SBP <110 mmHg were 2.47 (1.48-4.11), and for SBP ≥140 mmHg were 2.19 (1.19-4.01).
  • Similar findings were noted when using the most recent time-updated SBP.

Conclusions:

  • A U-shaped association exists between SBP and adverse clinical outcomes in Korean patients with CKD.
  • The findings emphasize the importance of BP control in CKD, suggesting that SBP <110 mmHg may pose a significant risk.
  • Further research is warranted to establish precise BP management guidelines for CKD patients, considering both hypotension and hypertension.
Abstract

Keywords:
CKDSBPcardiovascular outcomehypertensionmortality

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