Intensive BP Control Provides Little Benefit in Chronic Kidney Disease

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The researchers found that the cardiovascular benefit from intensive treatment was diminished with lower eGFR.
The researchers found that the cardiovascular benefit from intensive treatment was diminished with lower eGFR.

HealthDay News — Intensive blood pressure (BP) control may provide no benefit and may even be harmful for patients with moderate-to-advanced chronic kidney disease, according to a study published online in the Journal of Internal Medicine.

Yoshitsugu Obi, PhD, from the University of California Irvine Medical Center, and colleagues conducted post-hoc analysis of the Systolic Blood Pressure Intervention Trial to determine the risk-benefit profile of intensive BP control across estimated glomerular filtration rate (eGFR) levels.

The researchers found that the cardiovascular benefit from intensive treatment was diminished with lower eGFR (P interaction =.019), while eGFR did not alter the adverse effect on acute kidney injury (AKI; P interaction =.179). 

For the 891 participants with eGFR <45 mL/min/1.73 m2, intensive treatment did not reduce the cardiovascular outcome (hazard ratio [HR], 0.92; 95% CI, 0.62-1.38), while it increased AKI (HR, 1.73; 95% CI, 1.12-2.66).

"Intensive BP control may provide little or no benefit and even be harmful for patients with moderate-to-advanced chronic kidney disease," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

Reference

Obi Y, Kalantar-Zadeh K, Shintani A, Kovesdy CP, Hamano T. Estimated glomerular filtration rate and the risk–benefitprofile of intensive blood pressure control amongstnondiabetic patients: a post hoc analysis of a randomizedclinical trial [published online October 16, 2017]. J Intern Med. doi:10.1111/joim.12701

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