Kidney Week

Abstract: TH-PO212

Association Between Systolic Blood Pressure Time in Target Range and Progression of CKD: Findings from KNOW-CKD Study

Session Information

• Hypertension and CVD: Clinical - I
  November 02, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Hypertension and CVD

• 1602 Hypertension and CVD: Clinical

Authors

• Park, Cheol Ho, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)

Cheol Ho Park,

• Kim, Hyung Woo, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)

Hyung Woo Kim,

• Park, Jung Tak, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)

Jung Tak Park,

• Chang, Tae ik, National Health Insurance Service Ilsan Hospital, Goyang, Gyeonggi-do, Korea (the Republic of)

Tae ik Chang,

• Yoo, Tae-Hyun, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)

Tae-Hyun Yoo,

• Kang, Shin-Wook, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)

Shin-Wook Kang,

• Han, Seung Hyeok, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (the Republic of)

Seung Hyeok Han,

Background

Time-in-target range (TTR) is determined by the proportion of time during which the systolic blood pressure (SBP) remains within a defined range. It has emerged as a good metric for assessing SBP control over time. However, whether TTR of SBP can predict progression of chronic kidney disease (CKD) is uncertain.

Methods

We investigated the association between SBP-TTR during the first year of enrollment and CKD progression among 1,758 participants from KNOW-CKD (Korean Cohort Study for Outcomes in Patients With Chronic Kidney Disease). Participants were categorized into 4 groups according to SBP-TTR (0%, 1–50%, 51–99%, and 100%). The primary outcome was a composite kidney outcome of a ≥50% decline in eGFR from baseline measurement or the initiation of kidney replacement therapy.

Results

During a follow-up period of 9,212 person-years (median, 5.4 years), the composite outcome occurred 710 (40.4%) participants. In multivariable cause-specific hazard model, a 1-SD increase in SBP-TTR was associated with an 11% lower risk of the composite outcome (hazard ratio [HR], 0.89; 95% confidence interval [CI], 0.82–0.97). Additionally, compared to the patients with SBP-TTR 0%, the HRs (95% CIs) for the SBP-TTR 1–50%, 51–99%, and 100% were 0.86 (0.68–1.08), 0.77 (0.61–0.97), and 0.73 (0.56–0.95), respectively. Moreover, the corresponding slopes of eGFR decline were -2.71 (-3.13 to -2.30), -2.52 (-2.80 to -2.23), -2.25 (-2.50 to -2.01), and -2.06 (-2.34 to -1.78) ml/min/1.73m², respectively.

Conclusion

Higher SBP-TTR was associated with a decreased risk of CKD progression in patients with CKD.

Funding

• Government Support – Non-U.S.