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Visit-to-visit variability in blood pressure and kidney disease progression in IgA nephropathy

Chen Tang1,2,3, Xiao-Yan Zhang4, Ji-Cheng Lv1,2,3

  • 1Renal Division, Peking University First Hospital, Peking University Institute of Nephrology, Beijing, China.

Clinical Kidney Journal
|November 16, 2022
PubMed

Insights

Visit-to-visit variability in systolic blood pressure (SBP) is a significant risk factor for kidney disease progression in patients with immunoglobulin A nephropathy (IgAN). Higher SBP variability increases the risk of adverse kidney outcomes.

Area of Science:

  • Nephrology
  • Cardiovascular Medicine
  • Clinical Research

Background:

  • Visit-to-visit variability (VVV) in blood pressure (BP) is linked to cardiovascular events and kidney damage.
  • Limited data exist on the association between BP VVV and chronic kidney disease (CKD) progression in immunoglobulin A nephropathy (IgAN).

Purpose of the Study:

  • To investigate the relationship between BP VVV and IgAN progression.
  • To assess if BP variability predicts kidney disease progression in IgAN patients.

Main Methods:

  • 1376 IgAN patients were analyzed using standard deviation (SD), coefficient of variation (CV), and average real variability (ARV) to measure BP VVV.
  • Cox models were used to examine associations between BP VVV and composite kidney disease progression events (50% eGFR decline or kidney failure).

Main Results:

  • Higher SD in systolic BP (SBP) was significantly associated with an increased risk of kidney disease progression (HR 1.07 per SD increase).
  • Patients in the highest quartile of SD SBP had a 2.12-fold higher risk of composite kidney disease progression compared to the lowest quartile.
  • Variability in diastolic BP showed a similar trend, though not statistically significant; CV and ARV yielded similar findings.

Conclusions:

  • Systolic blood pressure variability is a significant predictor of kidney disease progression in patients with IgAN.
  • Managing SBP variability may be crucial for improving kidney outcomes in IgAN patients.
Abstract

Keywords:
IgA nephropathyblood pressureblood pressure variabilitychronic renal failurekidney disease progression

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