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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

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Cross-classification by systolic and diastolic blood pressure levels and chronic kidney disease, proteinuria, or

Tsukasa Suenaga1, Michihiro Satoh2,3, Takahisa Murakami1,4,5

  • 1Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan.

Hypertension Research : Official Journal of the Japanese Society of Hypertension
|March 30, 2023
PubMed

Insights

High blood pressure (BP), particularly elevated diastolic BP, significantly increases chronic kidney disease (CKD) risk in middle-aged adults. Monitoring BP is crucial for predicting and preventing CKD progression.

Area of Science:

  • Nephrology
  • Cardiology
  • Public Health

Background:

  • Predicting and preventing new-onset chronic kidney disease (CKD) is a significant public health concern.
  • Blood pressure (BP) is a modifiable risk factor for cardiovascular and kidney diseases.
  • Understanding the specific impact of systolic and diastolic BP on CKD risk is essential for targeted interventions.

Purpose of the Study:

  • To assess the risk of new-onset chronic kidney disease (CKD) based on cross-classification of systolic and diastolic blood pressure (SBP and DBP).
  • To identify which BP component, SBP or DBP, is more strongly associated with CKD development and progression.

Main Methods:

  • Retrospective population-based cohort study using the JMDC database of 1,492,291 Japanese participants (<75 years) without prior CKD or antihypertensive treatment.
  • Participants were followed for a mean of 3.2 years.
  • CKD was defined as proteinuria and/or an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m².

Main Results:

  • High SBP and DBP were both significantly associated with an elevated CKD risk compared to SBP/DBP <120/<80 mmHg.
  • Diastolic BP showed a stronger association with CKD risk than SBP.
  • SBP/DBP ≥150/<80 mmHg was strongly linked to increased eGFR decline, indicating a heightened risk of CKD progression.

Conclusions:

  • Elevated BP, especially isolated high diastolic BP, is a significant risk factor for CKD in middle-aged individuals without pre-existing kidney disease.
  • Close monitoring of kidney function, particularly eGFR decline, is recommended for individuals with low diastolic BP and very high systolic BP.
  • These findings underscore the importance of BP management in CKD prevention strategies.

Keywords:
Blood pressureChronic kidney diseaseEpidemiologyIsolated diastolic hypertensionIsolated systolic hypertension

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