Table 3.
Association of systolic and diastolic blood pressure with decline in renal function during the first year of pre-dialysis care
| n | Baseline eGFR* (ml/min/ 1.73 m2) |
Crude additional decline (ml/min/ 1.73 m2/month) |
Adjusted additional decline† (ml/min/ 1.73 m2/month) |
Adjusted additional decline‡ (ml/min/ 1.73 m2/month) |
|
|---|---|---|---|---|---|
| Systolic blood pressure (mmHg): | |||||
| Per 10 | 436 | 0.03 (0.01;0.06) | 0.04 (0.02;0.07) | 0.04 (0.02;0.07) | |
| < 130 | 79 | 14.0 | 0§ | 0 | 0 |
| 130-149 | 116 | 12.8 | 0.13 (-0.09;0.34) | 0.15 (-0.06;0.36) | 0.14 (-0.07;0.35) |
| 150-169 | 125 | 12.7 | 0.14 (-0.08;0.35) | 0.19 (-0.02;0.39) | 0.17 (-0.04;0.38) |
| 170-189 | 72 | 14.2 | 0.19 (-0.05;0.43) | 0.27 (0.04;0.51) | 0.24 (0.00;0.48) |
| ≥ 190 | 44 | 13.3 | 0.34 (0.06;0.61) | 0.44 (0.16;0.71) | 0.43 (0.15;0.70) |
| Diastolic blood pressure (mmHg): | |||||
| Per 10 | 436 | 0.07 (0.02;0.12) | 0.05 (0.00;0.10) | 0.05 (0.00;0.11) | |
| < 80 | 122 | 13.4 | 0γ | 0 | 0 |
| 80-89 | 151 | 13.7 | 0.08 (-0.10;0.26) | 0.06 (-0.12;0.23) | 0.07 (-0.11;0.25) |
| 90-99 | 98 | 13.3 | 0.12 (-0.07;0.32) | 0.12 (-0.08;0.31) | 0.12 (-0.08;0.32) |
| ≥ 100 | 65 | 11.9 | 0.29 (0.07;0.52) | 0.23 (0.00;0.45) | 0.22 (-0.01;0.44) |
| Blood pressure treatment target goal (mmHg): | |||||
| < 130/< 80 | 47 | 14.2 | 0^ | 0 | 0 |
| ≥ 130/< 80 | 75 | 13.0 | 0.21 (-0.07;0.48) | 0.31 (0.04;0.58) | 0.31 (0.04;0.58) |
| < 130/≥ 80 | 32 | 13.8 | 0.22 (-0.12;0.55) | 0.21 (-0.12;0.54) | 0.26 (-0.08;0.59) |
| ≥ 130/≥ 80 | 282 | 13.1 | 0.27 (0.04;0.50) | 0.30 (0.08;0.53) | 0.31 (0.08;0.53) |
The decline (95% confidence interval) presented for each blood pressure category indicates the additional decline in renal function compared to the reference category (systolic blood pressure (SBP) < 130 mmHg, diastolic blood pressure (DBP) < 80 mmHg, and SBP/DBP < 130/< 80 mmHg). A negative decline is equivalent to a slower decline in renal function.
* The mean estimated glomerular filtration rate (eGFR) in ml/min/1.73 m2 at baseline. † Adjusted for sex and age. ‡ Adjusted for sex, age, race, smoking, primary kidney disease, and the co-morbidities cardiovascular disease (CVD) and diabetes mellitus (DM). § The mean (standard deviation, SD) decline in renal function is 0.22 (0.74) ml/min/1.73 m2/month. γ The mean (SD) decline in renal function is 0.26 (0.90) ml/min/1.73 m2/month. ^The mean (SD) decline in renal function is 0.13 (0.85) ml/min/1.73 m2/month.