Abstract: SA-PO929
Short-Term Systolic Blood Pressure Variability Predicts Renal Events in CKD: Results from the C-STRIDE Study
Session Information
- CKD: Clinical, Outcomes, Trials - III
November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: CKD (Non-Dialysis)
- 2102 CKD (Non-Dialysis): 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
Whether short-term blood pressure variability (BPV) correlates with renal and cardiovascular (CV) events is controversial in patients with chronic kidney disease (CKD).
Methods
A total of 1421 CKD stage 1-4 patients with ambulatory BP (ABP) data from the Chinese Cohort Study of Chronic Kidney Disease (C-STRIDE) were enrolled in the present study. Short-term BPV was evaluated by calculating 24-hour standard deviation (SD) andthe weighted SD (w-SD) of systolic BP (SBP).The association of short-term BPV with CKD outcomes, including initiation of renal replacement therapy and CV events, was evaluated by Cox regression model. The adjustment included age, gender, smoking, diabetes, anti-hypertensive treatment, body mass index, serum albumin, estimated glomerular filtration rate, logarithm transformed low-density lipoprotein cholesterol and logarithm transformed urine protein.
Results
The mean age of the cohort was 49.4±13.7 years with 56% males. The average value of 24-hour SBP SD and w-SD were 13.9±4.8mmHg and 12.6±4.4mmHg, respectively. During a median follow-up of 4.8 years, 236 renal events and 93 CV events occurred, respectively.
Both 24-hour BP SD (hazard ratio [HR]: 1.04, 95% confidence interval [CI]: 1.01-1.06) and w-SD (HR: 1.05, 95%CI: 1.02-1.08) showed a greater hazard for renal events in fully adjusted model. Compared with the bottom tertile group, the risk for renal events was significantly increased in top tertile group for both 24-hour SBP SD (HR:1.58, 95%CI:1.11-2.24) and w-SD (HR:1.48, 95%CI: 1.07-2.06), respectively.
Neither 24-hour SBP SD nor w-SD showed a significant relationship with CV events when expressed as a continuous variable (HR: 1.04, 95% CI: 0.99–1.08 and HR: 1.03, 95% CI: 0.99–1.08, respectively). Similar findings were found with tertiled 24-hour SBP SD and w-SD.
Conclusion
In CKD patients, short-term systolic blood pressure variability increases the risk for renal events independently.