Blood pressure targets in patients with chronic kidney disease: MDRD and AASK now confirming SPRINT.
Pantelis A SarafidisCharalampos LoutradisAlberto OrtizLuis M RuilopePublished in: Clinical kidney journal (2020)
Recent American and European hypertension guidelines are not in agreement regarding blood pressure (BP) targets for persons with chronic kidney disease (CKD). Previous analyses from the African American Study on Kidney Disease (AASK) and Modification of Diet in Renal Disease (MDRD) trials suggested that strict BP control confers nephroprotection for patients with proteinuria, but a mortality benefit was not apparent. In contrast, an analysis of the Systolic Blood Pressure Intervention Trial (SPRINT) subpopulation of CKD patients showed a mortality benefit with the systolic blood pressure (SBP) <120 mmHg versus the SBP <140 target. A recent analysis of the combined MDRD and AASK cohorts supports previous evidence on nephroprotection but also findings from the SPRINT trial on all-cause mortality benefits of intensive versus usual BP control in individuals with CKD.
Keyphrases
- blood pressure
- chronic kidney disease
- end stage renal disease
- hypertensive patients
- african american
- heart rate
- study protocol
- high intensity
- randomized controlled trial
- cardiovascular events
- clinical trial
- peritoneal dialysis
- phase ii
- resistance training
- magnetic resonance
- heart failure
- phase iii
- blood glucose
- newly diagnosed
- risk factors
- type diabetes
- prognostic factors
- coronary artery disease
- computed tomography
- magnetic resonance imaging
- atrial fibrillation
- adipose tissue
- body composition
- skeletal muscle
- physical activity
- weight loss
- left ventricular
- insulin resistance
- patient reported
- diffusion weighted imaging