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Kidney Week

Abstract: TH-PO474

Hypertensive Epidemiology and Potential Blood Pressure Goals in IgA Nephropathy

Session Information

Category: Hypertension and CVD

  • 1401 Hypertension and CVD: Epidemiology, Risk Factors, and Prevention

Authors

  • Zheng, Ying, Chinese PLA General Hospital, Beijing, China
  • Wang, Yong, Chinese PLA General Hospital, Beijing, China
  • Duan, Shuwei, Chinese PLA General Hospital, Beijing, China
  • Cai, Guangyan, Chinese PLA General Hospital, Beijing, China
  • Chen, Xiangmei, Chinese PLA General Hospital, Beijing, China
Background

IgA nephropathy is the most prevalent form of primary glomerulonephritis worldwide. Hypertension is one of the most important risk factors in the progression of kidney disease. Our aim was to identify the epidemiology of hypertension in IgA nephropathy.

Methods

This was a nationwide, multi-center, cross-sectional study. We analyzed 1055 patients with IgA nephropathy from 61 tertiary hospitals in China (except Hong Kong, Macao, and Taiwan). Hypertension was defined as blood pressure (BP) ≥ 140/90 mmHg. Three BP goals were used to assess BP control: < 140/90 mmHg, < 130/80 mmHg, and < 125/75 mmHg. The outcomes included factors associated with hypertension, decreased renal function, and potential BP range goals for IgA nephropathy, which were analyzed based on 24-hour proteinuria levels of <1 g/d or ≥ 1 g/d.

Results

We found that 63.3% of our participants with IgA nephropathy had hypertension. Blood pressures were controlled under 140/90 mmHg in 49.1% of participants, 34.3% of patients with proteinuria <1 g/d reached the goal of BP <130/80 mmHg, and only 12.9% of patients with proteinuria >1 g/d achieved BP <125/75 mmHg. With proteinuria <1 g/d, the odds ratios (95% confidence interval) [ORs (95% CI)] of decreased renal function with BPs < 140/90 mmHg, < 130/80 mmHg, and < 125/75 mmHg were 0.9 (0.5 - 1.6), 1.0 (0.5 - 1.8), and 1.0 (0.5 - 2.0), respectively (P > 0.05). With proteinuria ≥1 g/d, the ORs of target BPs < 140/90 mmHg, < 130/80 mmHg, and < 125/75 mmHg were 0.4 (0.2 - 0.6), 0.2 (0.1 - 0.4), and 0.3 (0.1 - 0.5), respectively (P < 0.05).

Conclusion

Hypertension was prevalent in IgA nephropathy and hypertensive control was suboptimal. It might be rational to keep BP < 140/90 mmHg in patients with proteinuria <1 g/d, and < 130/80 mmHg in patients with proteinuria ≥1 g/d, respectively. Randomized clinical trials in IgA nephropathy are needed to evaluate BP range goals.