Kidney Week

Abstract: TH-PO227

Exploring the Spectrum of Blood Pressure Associations with CKD: The International 24-Hour Aortic Blood Pressure Consortium (i24ABC)

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

• Aoun Bahous, Sola, Lebanese American University School of Medicine, Byblos, Lebanon

Sola Aoun Bahous,

• Weber, Thomas, Klinikum Wels-Grieskirchen GmbH, Wels, Oberösterreich, Austria

Thomas Weber,

• Haddad, Chadia Souheil, Lebanese American University School of Medicine, Byblos, Lebanon

Chadia Souheil Haddad,

• Salameh, Pascale, Lebanese American University School of Medicine, Byblos, Lebanon

Pascale Salameh,

• De La Sierra, Alejandro, Universitat de Barcelona Facultat de Medicina i Ciencies de la Salut, Barcelona, Catalunya, Spain

Alejandro De La Sierra,

• Argyris, Antonios A., Ethniko kai Kapodistriako Panepistemio Athenon Iatrike Schole, Athens, Attica, Greece

Antonios A. Argyris,

• Hametner, Bernhard, Austrian Institute of Technology GmbH, Wien, Wien, Austria

Bernhard Hametner,

• Mayer, Christopher C., Austrian Institute of Technology GmbH, Wien, Wien, Austria

Christopher C. Mayer,

• Piskorz, Daniel Leonardo, Instituto de Cardiologia Sanatorio Britanico SA, Santa Fe, Argentina

Daniel Leonardo Piskorz,

• Terentes-Printzios, Dimitrios, Ethniko kai Kapodistriako Panepistemio Athenon, Athens, Attica, Greece

Dimitrios Terentes-Printzios,

• Rodilla, Enrique, Universidad Cardenal Herrera-CEU, Valencia, Spain

Enrique Rodilla,

• Gkaliagkousi, Eugenia, Aristoteleio Panepistemio Thessalonikes Schole Epistemon Ygeias, Thessaloniki, Central Macedonia, Greece

Eugenia Gkaliagkousi,

• Pierce, Gary L., The University of Iowa, Iowa City, Iowa, United States

Gary L. Pierce,

• Stergiou, George, Ethniko kai Kapodistriako Panepistemio Athenon, Athens, Attica, Greece

George Stergiou,

• Pucci, Giacomo, Universita degli Studi di Perugia, Perugia, Umbria, Italy

Giacomo Pucci,

• Blacher, Jacques, Hopital Hotel-Dieu de Paris, Paris, Île-de-France, France

Jacques Blacher,

• Kario, Kazuomi, Jichi Ika Daigaku, Shimotsuke, Tochigi, Japan

Kazuomi Kario,

• Muiesan, Maria Lorenza, Universita degli Studi di Brescia, Brescia, Lombardia, Italy

Maria Lorenza Muiesan,

• Agharazii, Mohsen, Universite Laval, Quebec, Quebec, Canada

Mohsen Agharazii,

• Jankowski, Piotr, Uniwersytet Jagiellonski w Krakowie Collegium Medicum, Krakow, Małopolskie, Poland

Piotr Jankowski,

• Perl, Sabine, Medizinische Universitat Graz, Graz, Steiermark, Austria

Sabine Perl,

• Wassertheurer, Siegfried, Austrian Institute of Technology GmbH, Wien, Wien, Austria

Siegfried Wassertheurer,

• Zhang, Yi, Shanghai Tenth People's Hospital, Shanghai, China

Yi Zhang,

• Orter, Stefan, Austrian Institute of Technology GmbH, Wien, Wien, Austria

Stefan Orter,

• Protogerou, Athanase, Ethniko kai Kapodistriako Panepistemio Athenon Iatrike Schole, Athens, Attica, Greece

Athanase Protogerou,

Group or Team Name

• The International 24-Hour Aortic Blood Pressure Consortium (i24ABC).

Background

Chronic kidney disease (CKD) has emerged as a significant public health concern. The kidneys are primarily exposed to pulsatile rather than steady hemodynamics, which complicates the bidirectional relationship between CKD and hypertension. We aimed to explore relationships between blood pressure (BP) parameters and renal function in a pooled dataset from 21 centers worldwide.

Methods

The dataset included clinical and hemodynamic information. All participants underwent office BP measurements, in addition to 24-hour ambulatory BP monitoring (ABPM) with the same validated automated brachial oscillometric device (Mobil-O-Graph, I.E.M., Germany) using a transfer function for central pressure, and mean/diastolic pressure calibration. Renal function was estimated using the CKD-EPI equation and subjects classified into the 6 eGFR categories following the KDIGO 2021 guideline.

Results

We included 5204 subjects, 46.1% females, with a mean age of 60.8 ± 13.9 years. Diabetes was noted in 14.7% and hypertension in 70.3% of subjects, 76% of whom were on antihypertensive therapy. The mean eGFR was 88.5 ± 19.9 mL/min/1.73 m². More than half of the participants (56.5%) had a normal or high eGFR (G1) and only 1.9% had a severely decreased eGFR (G5). The prevalence of hypertension increased progressively across GFR categories with 95.7% of subjects in G5 vs. 67.7% in G1 (p<0.001) with hypertension. Diastolic BP tended to decrease (p<0.001) and SBP to increase (p<0.001) with decreasing eGFR. These associations were consistent for both brachial and central values, and for office and ABPM measurement techniques. Systolic reverse dipping status was independently associated with decreased eGFR after adjustment for gender and age, and irrespective of hypertension status (β=-1.74, p=0.004).

Conclusion

CKD is associated with adverse hemodynamic changes, both at the brachial and the aortic level, and in office and out-of-office measurements, indicative of arterial stiffening.