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Background <p>Prior studies in the CKiD (Chronic Kidney Disease in Children) cohort have shown poor blood pressure (BP) control over time. It is unclear whether the lack of BP control is associated with frequency of provider contact between annual study visits.</p> Methods <p>Six hundred eighty-nine CKiD participants with elevated BP or self-reported history of hypertension contributed longitudinal annual data (2,916 total visits). Provider visits were categorized as any well or sick visit, excluding emergency department visits. Repeated measures logistic regression quantified the association between number of visits over the last year (categorized as 0, 1–2, 3–5, 6–10 or &gt; 10 visits) and BP control (defined as non-elevated BP at an annual CKiD visit). Models were unadjusted, minimally adjusted (controlling for sociodemographic factors), and fully adjusted (additionally controlling for chronic kidney disease (CKD) severity).</p> Results <p>Compared to those with no interval healthcare provider visits over the prior year, participants with 3–5 visits had significantly greater odds of BP control across all models (unadjusted, OR 1.45, 95% CI 1.10–1.89; minimally adjusted, OR 1.36, 95% CI 1.03–1.79; fully adjusted, OR 1.36, 95% CI 1.01–1.81); those with fewer or more frequent visits did not consistently have significant improvement in BP control.</p> Conclusions <p>In this cohort of youth with CKD and elevated BP, interval healthcare provider contact of 3–5 visits per year between annual CKiD visits was associated with improved BP control; less and more frequent contact was not, even after adjusting for CKD severity. Optimal frequency of health visits by CKD and comorbidity severity deserves further study.</p> Graphical Abstract <p></p>

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Interval healthcare provider contact and blood pressure control in children with chronic kidney disease and hypertension

  • 期刊论文

  • 发表日期：

    2025年3月24日

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  • John H. Hammond,
  • Derek K. Ng,
  • Eliza D. Blanchette,
  • Joseph T. Flynn,
  • Mark M. Mitsnefes,
  • Susan L. Furth,
  • Bradley A. Warady,
  • Tammy M. Brady

摘要

Background

Prior studies in the CKiD (Chronic Kidney Disease in Children) cohort have shown poor blood pressure (BP) control over time. It is unclear whether the lack of BP control is associated with frequency of provider contact between annual study visits.

Methods

Six hundred eighty-nine CKiD participants with elevated BP or self-reported history of hypertension contributed longitudinal annual data (2,916 total visits). Provider visits were categorized as any well or sick visit, excluding emergency department visits. Repeated measures logistic regression quantified the association between number of visits over the last year (categorized as 0, 1–2, 3–5, 6–10 or > 10 visits) and BP control (defined as non-elevated BP at an annual CKiD visit). Models were unadjusted, minimally adjusted (controlling for sociodemographic factors), and fully adjusted (additionally controlling for chronic kidney disease (CKD) severity).

Results

Compared to those with no interval healthcare provider visits over the prior year, participants with 3–5 visits had significantly greater odds of BP control across all models (unadjusted, OR 1.45, 95% CI 1.10–1.89; minimally adjusted, OR 1.36, 95% CI 1.03–1.79; fully adjusted, OR 1.36, 95% CI 1.01–1.81); those with fewer or more frequent visits did not consistently have significant improvement in BP control.

Conclusions

In this cohort of youth with CKD and elevated BP, interval healthcare provider contact of 3–5 visits per year between annual CKiD visits was associated with improved BP control; less and more frequent contact was not, even after adjusting for CKD severity. Optimal frequency of health visits by CKD and comorbidity severity deserves further study.

Graphical Abstract