Association of Intensive Blood Pressure Control and Kidney Disease Progression in Nondiabetic Patients With CKD

MedicalResearch.com Interview with:
Hon-Yen Wu, MD, PhD, on behalf of all authors

Attending Physician and Assistant Professor, Division of Nephrology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
Assistant Professor, Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan.
Assistant Professor, National Taiwan University Hospital and College of Medicine,
National Taiwan University, Taipei, Taiwan.
Assistant Professor, School of Medicine, National Yang-Ming University, Taipei, Taiwan. 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The effect of intensive blood pressure (BP) control in nondiabetic patients with chronic kidney disease (CKD) has long been a topic of debate. We summarized the published information comparing intensive BP control (< 130/80 mmHg) with standard BP control (< 140/90 mmHg) on major renal outcomes in CKD patients without diabetes. We pooled data from 9 randomized clinical trials with more than 8000 patients and over 800 events of kidney disease progression. We found that targeting blood pressure below the current standard did not provide additional benefit for renal outcomes compared with standard BP control, but may benefit nonblack patients or those with heavy proteinuria.

MedicalResearch.com: What should readers take away from your report?

Response: For the optimal blood pressure target in CKD patients without diabetes, an individually tailored treatment rather than a general rule to control hypertension is suggested.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Response: Most of the included studies had a trial follow-up time shorter than 4 years, the length of follow-up might not be long enough to distinguish differences among the renal outcomes. Further trials with longer follow-up time are deserved to examine the effect of intensive blood pressure control on renal outcomes in nondiabetic patients with chronic kidney disease.

MedicalResearch.com: Is there anything else you would like to add?

Response: The present study was designed to evaluate CKD patients without diabetes, and focused on renal outcomes. Further studies are needed to evaluate the effects of intensive blood pressure control in patients with diabetic kidney disease. 

MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.

Citation:

Tsai W, Wu H, Peng Y, Yang J, Chen H, Chiu Y, Hsu S, Ko M, Pai M, Tu Y, Hung K, Chien K. Association of Intensive Blood Pressure Control and Kidney Disease Progression in Nondiabetic Patients With Chronic Kidney Disease A Systematic Review and Meta-analysis. JAMA Intern Med. Published online March 13, 2017. doi:10.1001/jamainternmed.2017.0197

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

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