Scholarlink

Background <p>Hypertension is a major risk factor for the progression of chronic kidney disease (CKD). However, the impact of blood pressure (BP) load, especially when office BP is normal, remains unclear. Thus, we conducted a retrospective cohort study to elucidate the impact of elevated BP load in patients with biopsy-proven CKD, BP load elevation, and a normal office BP compared with normotensive patients with CKD but without BP load elevation and those with hypertension.</p> Methods <p>We retrospectively analyzed patients with histologically confirmed atherosclerotic CKD who underwent kidney biopsy and 24-h ambulatory BP monitoring (ABPM). Patients were classified into normotension, isolated BP load elevation, and hypertension groups. The primary outcome was a ≥ 30% sustained decline in estimated glomerular filtration rate (eGFR) within 3&#xa0;years.</p> Results <p>A total of 57 patients were analyzed. The isolated BP load elevation and hypertension groups showed a significantly higher incidence of adverse kidney events than the normotension group (p &lt; 0.01). After adjusting for confounding factors (age, sex, urinary protein, and Mayo Clinic Chronicity Score), the hazard for kidney outcomes remained significant in the isolated BP load elevation group (hazard ratio, 9.25; 95% confidence interval, 1.29–66.30).</p> Conclusions <p>Isolated BP load elevation is a significant risk factor for CKD progression even in patients with normal office BP. Normalization of BP load may be a potential therapeutic target in patients with CKD. Comprehensive BP assessment using 24-h ABPM is crucial for CKD management, as it reveals clinically important abnormalities that conventional measurements may not capture.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Blood pressure load associated with progressive kidney function decline in biopsy-proven atherosclerotic chronic kidney disease patients

  • 期刊论文

  • 发表日期：

    2025年8月4日

查看全文
  • Hiroki Nobayashi,
  • Go Kanzaki,
  • Haruki Mae,
  • Kotaro Haruhara,
  • Nobuo Tsuboi,
  • Takashi Yokoo

摘要

Background

Hypertension is a major risk factor for the progression of chronic kidney disease (CKD). However, the impact of blood pressure (BP) load, especially when office BP is normal, remains unclear. Thus, we conducted a retrospective cohort study to elucidate the impact of elevated BP load in patients with biopsy-proven CKD, BP load elevation, and a normal office BP compared with normotensive patients with CKD but without BP load elevation and those with hypertension.

Methods

We retrospectively analyzed patients with histologically confirmed atherosclerotic CKD who underwent kidney biopsy and 24-h ambulatory BP monitoring (ABPM). Patients were classified into normotension, isolated BP load elevation, and hypertension groups. The primary outcome was a ≥ 30% sustained decline in estimated glomerular filtration rate (eGFR) within 3 years.

Results

A total of 57 patients were analyzed. The isolated BP load elevation and hypertension groups showed a significantly higher incidence of adverse kidney events than the normotension group (p < 0.01). After adjusting for confounding factors (age, sex, urinary protein, and Mayo Clinic Chronicity Score), the hazard for kidney outcomes remained significant in the isolated BP load elevation group (hazard ratio, 9.25; 95% confidence interval, 1.29–66.30).

Conclusions

Isolated BP load elevation is a significant risk factor for CKD progression even in patients with normal office BP. Normalization of BP load may be a potential therapeutic target in patients with CKD. Comprehensive BP assessment using 24-h ABPM is crucial for CKD management, as it reveals clinically important abnormalities that conventional measurements may not capture.