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Updated: Aug 14, 2025

Assessment of Vascular Function in Patients With Chronic Kidney Disease
Published on: June 16, 2014
Blood Pressure Variability and the Progression of Chronic Kidney Disease: a Systematic Review and Meta-Analysis
Letian Yang1, Jian Li2, Wei Wei1
1Division of Nephrology, Kidney Research Institute, West China Hospital of Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, China.
Background:
Blood pressure variability (BPV) is a risk factor for poor prognosis including cardiovascular events, chronic kidney disease, and mortality, independent of elevated BP.
Methods:
We searched PubMed/Medline, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL) from inception to November 23, 2022. Cohort studies reporting the association between BPV and chronic kidney disease (CKD) progression were selected. Hazard ratios were pooled using a random-effects model. Meta-regression, subgroup analyses, and sensitivity analyses were conducted.
Results:
A total of 23 studies were included in this systematic review and meta-analysis. Increased BPV was associated with progression of CKD (HR: 1.21, 95% CI: 1.09-1.33) and incidence of ESRD (HR: 1.08, 95% CI: 1.08-1.30). Among the different BPV metrics, high variation independent of mean (VIM), coefficient of variation (CV), standard deviation (SD), and average real variability (ARV) were indicated as predictors of CKD progression.
Discussion:
Increased BPV was associated with CKD progression.
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