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Cited by 475

The DOI matches its Crossref record; 6 of the 6 references it cites were found in a registry or an index.

Effects of Intensive BP Control in CKD

Open access
Cheung, Alfred K., Rahman, Mahboob, Reboussin, David M., Craven, Timothy E., Greene, Tom, Kimmel, Paul L., Cushman, William C., Hawfield, Amret T., Johnson, Karen C., Lewis, Cora E., Oparil, Suzanne, Rocco, Michael V., Sink, Kaycee M., Whelton, Paul K., Wright, Jackson T., Basile, Jan, Beddhu, Srinivasan, Bhatt, Udayan, Chang, Tara I., Chertow, Glenn M., Chonchol, Michel, Freedman, Barry I., Haley, William, Ix, Joachim H., Katz, Lois A., Killeen, Anthony A., Papademetriou, Vasilios, Ricardo, Ana C., Servilla, Karen, Wall, Barry, Wolfgram, Dawn, Yee, Jerry, for the SPRINT Research Group·2017·Journal of the American Society of Nephrology
DOI 10.1681/asn.2017020148
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Abstract

The appropriate target for BP in patients with CKD and hypertension remains uncertain. We report prespecified subgroup analyses of outcomes in participants with baseline CKD in the Systolic Blood Pressure Intervention Trial. We randomly assigned participants to a systolic BP target of <120 mm Hg (intensive group; n =1330) or <140 mm Hg (standard group; n =1316). After a median follow-up of 3.3 years, the primary composite cardiovascular outcome occurred in 112 intensive group and 131 standard group CKD participants (hazard ratio [HR], 0.81; 95% confidence interval [95% CI], 0.63 to 1.05). The intensive group also had a lower rate of all-cause death (HR, 0.72; 95% CI, 0.53 to 0.99). Treatment effects did not differ between participants with and without CKD ( P values for interactions ≥0.30). The prespecified main kidney outcome, defined as the composite of ≥50% decrease in eGFR from baseline or ESRD, occurred in 15 intensive group and 16 standard group participants (HR, 0.90; 95% CI, 0.44 to 1.83). After the initial 6 months, the intensive group had a slightly higher rate of change in eGFR (−0.47 versus −0.32 ml/min per 1.73 m 2 per year; P <0.03). The overall rate of serious adverse events did not differ between treatment groups, although some specific adverse events occurred more often in the intensive group. Thus, among patients with CKD and hypertension without diabetes, targeting an SBP<120 mm Hg compared with <140 mm Hg reduced rates of major cardiovascular events and all-cause death without evidence of effect modifications by CKD or deleterious effect on the main kidney outcome.

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Authors
Cheung, A. K., Rahman, M., Reboussin, D. M., Craven, T. E., Greene, T., Kimmel, P. L., Cushman, W. C., Hawfield, A. T., Johnson, K. C., Lewis, C. E., Oparil, S., Rocco, M. V., Sink, K. M., Whelton, P. K., Wright, J. T., Basile, J., Beddhu, S., Bhatt, U., Chang, T. I., Chertow, G. M., Chonchol, M., Freedman, B. I., Haley, W., Ix, J. H., Katz, L. A., Killeen, A. A., Papademetriou, V., Ricardo, A. C., Servilla, K., Wall, B., Wolfgram, D., Yee, J., & for the SPRINT Research Group
Venue
Journal of the American Society of Nephrology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2017-06-22
Volume
28
Issue
9
Pages
2812-2823
ISSN
  • 1046-6673 (ISSN-L)
  • 1533-3450
DOI
10.1681/asn.2017020148
OpenAlex
W2629112697
Cited by
475
References
6
FWCI
30.80
Type
journal article
Language
en
Open access
green

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