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Kidney Week

Abstract: TH-OR105

White-Coat Hypertension Has a Predictive Role for Renal Outcome in Patients with Non-Dialysis CKD: Results from the C-STRIDE Study

Session Information

Category: Hypertension and CVD

  • 1402 Hypertension and CVD: Clinical, Outcomes, and Trials

Authors

  • Wang, Qin, Renal Division, Department of Medicine, Peking University First Hospital; Peking University Institute of Nephrology, Beijing, BeiJing, China
  • Wang, Jinwei, Renal Division, Department of Medicine, Peking University First Hospital; Peking University Institute of Nephrology, Beijing, BeiJing, China
  • Wang, Yu, Renal Division, Department of Medicine, Peking University First Hospital; Peking University Institute of Nephrology, Beijing, BeiJing, China
  • Zhang, Luxia, Renal Division, Department of Medicine, Peking University First Hospital; Peking University Institute of Nephrology, Beijing, BeiJing, China
  • Zhao, Ming Hui, Renal Division, Department of Medicine, Peking University First Hospital; Peking University Institute of Nephrology, Beijing, BeiJing, China
Background

Data on the predictive value of white-coat hypertension (WCH) for renal and cardiovascular (CV) outcomes in patients with chronic kidney disease (CKD) is controversial.

Methods

Totally, 1734 CKD stage 1-4 patients with both ambulatory BP (ABP) and clinic BP (CBP) data from the Chinese Cohort Study of Chronic Kidney Disease (C-STRIDE) were enrolled in the present study. The BP pattern was categorized as normotension(NT), WCH, masked hypertension (MH) and sustained hypertension (SH) according to ABP and CBP values, respectively.The association of BP pattern with CKD outcomes, including initiation of renal replacement therapy and CV events, was evaluated by Cox regression model.

Results

The mean age of the cohort was 48.8±13.7 years with 43.2% females.The average value of ABP and CBP were 128±17/79±11mm Hg and 130±18/81±10mm Hg, respectively. And NT, WCH, MH and SH each had 678(39.1%), 83(4.8%), 538(31%) and 435(25.1%) patients.During a median follow-up of 4.7 years, 287 renal events and 128 CV events occurred, respectively. Compared with NT, the fully adjusted risk for renal events was significantly increased in WCH(hazard ratio [HR] 2.43; 95% confidence interval [CI] 1.38-4.31), MH (HR 2.42; 95%CI 1.66-3.50), and SH (HR 2.56; 95%CI 1.75-3.74), respectively.With regard to CV events, WCH, MH and SH also showed higher risk after adjusting for traditional CV risk factors (HR 2.53, 95%CI 1.21-5.29; HR 1.85, 95%CI 1.13-3.01; HR 2.63, 95%CI 1.63-4.25, respectively). After further adjusting baseline logarithm transformed 24h-urinary protein and estimated glomerular filtrationrate, only SH showed a significantly increased risk for CV events (HR 1.81; 95%CI 1.10-2.99).

Conclusion

WCH is independently associated with an increased risk for renal events in non-dialysis CKD patients.