Blood Pressure Components and End-Stage Renal Disease in Persons with Chronic Kidney Disease

People with chronic kidney disease who have high blood pressure are at risk of progressing to end-stage renal disease. Meeting blood pressure goals, however, is challenging.

These researchers sought to determine the independent association between systolic and diastolic blood pressure (BP) and the risk of end-stage renal disease (ESRD). The participants were part of the Kidney Early Evaluation Program, a health screening program for people with kidney disease, a history of diabetes or hypertension, or a family history of kidney disease.

Compared to people with a systolic BP under 130 mm Hg, those with a systolic BP of 140 to 149 mm Hg had higher rates of ESRD; those with systolic BP 150 mm Hg had double rates of ESRD. Only persons with a diastolic BP of 90 mm Hg or higher remained at a significantly higher risk of ESRD compared with those with a diastolic BP of 60 to 74 mm Hg. Race, diabetes and severity of chronic kidney disease did not significantly modify these results.

These findings from a large, community-based study suggest that a blood pressure goal of 140/90, rather than the more aggressive and difficult-to-attain 130/80, may be sufficient for people with chronic kidney disease.