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Kidney Week

Abstract: FR-PO173

Wide Pulse Pressure as a Risk Factor for Kidney Dysfunction

Session Information

Category: CKD (Non-Dialysis)

  • 1901 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

  • Toyama, Tadashi, Division of Nephrology, Kanazawa University Hospital, Kanazawa, ishikawa, Japan
  • Kitajima, Shinji, Division of Nephrology, Kanazawa University Hospital, Kanazawa, ishikawa, Japan
  • Hara, Akinori, Division of Nephrology, Kanazawa University Hospital, Kanazawa, ishikawa, Japan
  • Kitagawa, Kiyoki, Kanazawa Medical Center, Kanazawa, ISHIKAWA, Japan
  • Iwata, Yasunori, Division of Nephrology, Kanazawa University Hospital, Kanazawa, ishikawa, Japan
  • Sakai, Norihiko, Division of Nephrology, Kanazawa University Hospital, Kanazawa, ishikawa, Japan
  • Shimizu, Miho, Division of Nephrology, Kanazawa University Hospital, Kanazawa, ishikawa, Japan
  • Furuichi, Kengo, Division of Nephrology, Kanazawa University Hospital, Kanazawa, ishikawa, Japan
  • Wada, Takashi, Division of Nephrology, Kanazawa University Hospital, Kanazawa, ishikawa, Japan
Background

The risk of kidney dysfunction due to hypertension has been drawing attention especially for people who have the characteristics of advanced arteriosclerosis. However, the relationships from the aspect of systemic arteriosclerosis were not well known. Pulse pressure (PP) is a routinely measured vital sign and is thought to reflect the arteriosclerosis of elastic arteries. The aim of this study is to clarify the relationships between pulse pressure for development of kidney dysfunction. Risks related to systolic blood pressure (SBP) according to wide pulse pressure was also studied.

Methods

People aged 40 years or older who had a medical checkup in Kanazawa city were included in the analysis. Kidney dysfunction was defined as a decline of eGFR by 30% from baseline. PP was classified as normal (40–60 mmHg) and wide (>60 mmHg). Cox proportional hazard model was used to estimate the risks for kidney dysfunction associated with wide PP and SBP.

Results

A total of 36,134 people was included in the analysis. The mean age was 69 years. Incidence rates of kidney dysfunction for people with normal and wide PP were 8.1 and 15.2 (per 1000 person-years), respectively. After multivariable adjustments, hazard ratio for the kidney dysfunction associated with wide pulse pressure compared with normal pulse pressure was 1.40 (95% CI 1.25 – 1.57). In the stratified analysis by baseline PP, hazard ratios related to higher SBP (+10 mmHg) in normal and wide PP group were 1.14 (95%CI 1.07 – 1.22) and 1.12 (95%CI 1.06–1.19), respectively. Among the people with wide PP, people with baseline SBP ≥160 mmHg showed significant risk (HR 1.52 [95%CI 1.03–2.24]) compared with the people with SBP 120 – <130 mmHg (reference), whereas SBP 130 – 160 mmHg was not related to significant risks.

Conclusion

Wide PP was associated with higher risks for kidney dysfunction. More studies are needed regarding the risks related to mild hypertension accompanied by wide PP.