Short‐Term Systolic Blood Pressure Variability and Kidney Disease Progression in Patients With Chronic Kidney Disease: Results From C‐STRIDE

Author:

Wang Qin12,Wang Yu12,Wang Jinwei12,Zhang Luxia123,Zhao Ming‐Hui124,Wang Xiaoqin,Yuan Jun,Zhou Qiaoling,Yuan Qiongjing,Chen Menghua,Zhou Xiaoling,Fu Shuxia,Li Shaomei,Zha Yan,Huang Rongsai,Liu Zhangsuo,Zhang Jun,Wang Li,Pu Lei,Liu Jian,Li Suhua,Xiong Zuying,Liang Wei,Zhao Jinghong,Mu Jiao,Lian Xiyan,Liao Yunjuan,Gan Hua,Liao Liping,Wang Rong,Lv Zhimei,Liao Yunhua,Pan Ling,Yang Xiaoping,Lin Zhifeng,Tong Zongwu,Zhu Yun,He Qiang,Wu Fuquan,Li Rong,Rong Kai,Wang Caili,Zhang Yanhui,Wang Yue,Tang Wen,Wu Hua,Zhao Ban,Li Rongshan,Wang Lihua,Li Detian,Du Feng,Wu Yonggui,Zhang Wei,Lin Shan,Xu Pengcheng,Lin Hongli,Hu Zhao,Pei Fei,Zhang Haisong,Gao Yan,Sun Luying,Li Xia,Wang Wenke,Lv Fengling,Wang Deguang,Wang Xuerong,Xu Dongmei,Tang Lijun,Ma Yingchun,Wang Tingting,Fu Ping,Wang Tingli,Xing Changying,Zhang Chengning,Xu Xudong,He Haidong,Liao Xiaohui,Xie Shuqin,Hu Guicai,Huang Lan

Affiliation:

1. Renal Division Department of Medicine Peking University First Hospital Institute of Nephrology Peking University Beijing China

2. Key Laboratory of Renal Disease National Health and Family Planning Commission of the People’s Republic of China Key Laboratory of Chronic Kidney Disease Prevention and Treatment Ministry of Education Beijing China

3. Center for Data Science in Health and Medicine Peking University Beijing China

4. Peking‐Tsinghua Center for Life Sciences Beijing China

Abstract

Background It is unclear whether short‐term blood pressure variability is associated with renal outcomes in patients with chronic kidney disease. Methods and Results This study analyzed data from participants in the C‐ STRIDE (Chinese Cohort Study of Chronic Kidney Disease) who had chronic kidney disease stages 1 to 4. Short‐term blood pressure variability was measured by calculating the weighted SD (w‐ SD ) of systolic blood pressure ( SBP ). Renal outcomes were defined as dialysis initiation and/or transplantation. Risk factors associated with w‐ SD of SBP were evaluated by linear regression. Associations of short‐term SBP variability with renal outcomes were evaluated by Cox regression. In total, 1421 patients with chronic kidney disease were included in this study (mean age, 49.4±13.6 years; 56.2% men; estimated glomerular filtration rate, 50.5±29.3 mL/min per 1.73 m 2 ; proteinuria, 0.9 [0.3–2.0] g/d). Mean w‐ SD of SBP was 12.6±4.4 mm Hg. w‐ SD of SBP was independently associated with older age, 24‐hour SBP , blood pressure circadian pattern, and angiotensin II receptor blocker treatment. During a median follow‐up of 4.9 years, 237 patients developed renal outcomes (37.01 per 1000 patient‐years). The incidence rate increased across the quartiles of w‐ SD (log‐rank P =0.005). w‐ SD of SBP was associated with an increased risk of renal outcomes, both as a continuous variable (hazard ratio [HR], 1.47; 95% CI, 1.09–1.99) and as a categorical variable (quartile 4 versus quartile 1: HR, 1.60; 95% CI, 1.08–2.36), independent of 24‐hour SBP , daytime SBP , and nighttime SBP . Conclusions Short‐term SBP was independently associated with the risk of dialysis initiation and/or transplantation in patients with chronic kidney disease .

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Cardiology and Cardiovascular Medicine

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