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Abstract: PO2065

Blood Pressure in Young Adults with CKD and Associations with Cardiovascular Events and CKD Progression

Session Information

Category: Hypertension and CVD

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

Authors

  • Kula, Alexander J., Seattle Children's Hospital, Seattle, Washington, United States
  • Bansal, Nisha, University of Washington, Seattle, Washington, United States
  • Prince, David K., University of Washington, Seattle, Washington, United States
  • Flynn, Joseph T., Seattle Children's Hospital, Seattle, Washington, United States
Background

Young adults (age 18-40yrs) with CKD are a poorly studied subset of CKD patients. Blood-pressure management for young adults with CKD relies on extrapolating findings from studies conducted in older adults or children. Our objective was to perform an observational study exclusively in young adults with CKD to test the association between BP and adverse outcomes.

Methods

Participants aged 21-40yrs of age enrolled in the Chronic Renal Insufficiency Cohort Study were included (n=317). Exposures included baseline systolic BP (SBP) category, <120, 120-120, ≥130, and per +10 higher baseline SBP. Outcomes included cardiovascular (CV) events, including heart failure, myocardial infarction, stroke, or all-cause death, and CKD progression, defined as 50% eGFR decline or ESRD. We used cox-proportional hazard models to test association between baseline SBP with outcomes. Adjusted models included age, race, eGFR, diabetes, with prevalent CV disease for CV event models and urine albumin to creatinine ratio for CKD progression.

Results

As seen in Figure 1, incidence rates for HF, death, CV events, and CKD progression were greater at higher SBP categories. In adjusted models, a baseline SBP >130 was significantly associated with CV events (HR: 3.32, 95% CI: 1.53-7.20) and CKD progression (HR: 1.63, 95%CI: 1.02-2.59) compared with SBP<120. Every +10 in SBP was significantly associated with CKD progression (HR: 1.13, 95%CI: 1.02-1.26) in adjusted models.

Conclusion

There is a graded association of higher SBP with greater risk of CV events and CKD progression in young adults with CKD. Among those with SBP>130, 5.8% per year had a CV event and risk was 3-fold higher compared with SBP<120; and 20.7% per year had CKD progression and risk was nearly 2-fold higher. These data suggest that higher SBP is an important risk factor for adverse outcomes in young adults with CKD.

Funding

  • NIDDK Support