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Kidney Week

Abstract: TH-PO621

Associations Between Blood Pressure (BP) and Risk of CKD: A Clinically Adjudicated Study of 0.5 Million Chinese Adults

Session Information

Category: Hypertension and CVD

  • 1501 Hypertension and CVD: Epidemiology‚ Risk Factors‚ and Prevention

Authors

  • Ng, Sarah Yoon Ai, MRC Clinical Trial Service Unit and Epidemiological Studies Unit, Oxford, Oxfordshire, United Kingdom
  • Sardell, Rebecca J., MRC Clinical Trial Service Unit and Epidemiological Studies Unit, Oxford, Oxfordshire, United Kingdom
  • Chen, Peiling, National Clinical Research Center for Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
  • Chen, Guang, National Clinical Research Center for Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
  • Wang, Jingjing, National Clinical Research Center for Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
  • Cheng, Shuiqin, National Clinical Research Center for Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
  • Fan, Wenjing, National Clinical Research Center for Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
  • Liu, Xia, National Clinical Research Center for Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
  • Chen, Zhengming, MRC Clinical Trial Service Unit and Epidemiological Studies Unit, Oxford, Oxfordshire, United Kingdom
  • Liu, Zhihong, National Clinical Research Center for Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
  • Chen, Yiping, MRC Clinical Trial Service Unit and Epidemiological Studies Unit, Oxford, Oxfordshire, United Kingdom
  • Baigent, Colin, MRC Clinical Trial Service Unit and Epidemiological Studies Unit, Oxford, Oxfordshire, United Kingdom
  • Staplin, Natalie, MRC Clinical Trial Service Unit and Epidemiological Studies Unit, Oxford, Oxfordshire, United Kingdom
  • Herrington, William G., MRC Clinical Trial Service Unit and Epidemiological Studies Unit, Oxford, Oxfordshire, United Kingdom
Background

Observational studies from China show a positive, log-linear relationship between high BP with CKD, but have not adjudicated outcomes.

Methods

The China Kadoorie Biobank is a cohort of 0.5 million adults from 5 urban and 5 rural areas of China aged 30-79 years at recruitment between 2004-2008. Hospitalized kidney outcomes were ascertained by prospective linkage to health insurance databases with medical notes reviewed by nephrologist adjudicators. Cox models estimated associations between long-term average (i.e. “usual”) BP with risk of CKD. Analyses were performed by time since recruitment and by kidney diagnosis.

Results

During a median of 11.1 years follow-up, 3,337 participants were hospitalized with CKD. Mean (SD) eGFR of adjudicator-confirmed CKD was 37.6 (27.0) ml/min/1.73m2. Each 10 mmHg higher usual SBP and 5 mmHg higher DBP were associated with a 28% (HR 1.28, 95% CI 1.25-1.32) and 24% higher risk (1.24, 1.21-1.28) of incident CKD (Fig 1). BP-CKD associations were unmodified by time since recruitment but the strengths of associations differed by kidney diagnosis. HRs for diabetic kidney disease, hypertensive nephropathy and glomerulonephritis per 10 mmHg higher SBP were 1.24 (1.14-1.35), 1.65 (1.52-1.78) and 1.18 (1.06-1.32) respectively (Fig 2).

Conclusion

Higher BP is linked to a range of kidney diseases with stronger associations in hypertensive nephropathy. Randomized data are needed to confirm causality.