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논문분류	춘계학술대회 초록집
제목	Association between Blood Pressure and Chronic Kidney Disease Progression in Patients with Advanced Chronic Kidney Disease: Findings from KNOW-CKD Study
저자	Cheol Ho Park
출판정보	2024; 2024(1):
키워드
초록	Objectives: Blood pressure (BP) control is an important component in the management of chronic kidney disease (CKD). However, whether BP control provides benefits in delaying the progression of CKD remains uncertain in patients with advanced CKD. Methods: We investigated the association between BP levels and CKD progression among 1,790 participants enrolled in KNOW-CKD (Korean Cohort Study for Outcomes in Patients With Chronic Kidney Disease) with an estimated glomerular filtration rate (eGFR) <45 ml/min/1.73 m2. The main predictors were baseline and time-updated systolic BP (SBP) and diastolic BP (DBP). The primary outcome was a composite kidney outcome of ≥50% decline in eGFR from baseline measurement or the initiation of kidney replacement therapy. Results: During 5,646 person-years of follow-up (median, 2.4 years), the composite outcome occurred 767 (42.8%) participants. Compared with baseline SBP <120 mmHg, the hazard ratios (HRs) (95% CIs) for 120–129, 130–139, and ≥140 mmHg were 1.19 (0.97–1.48), 1.17 (0.94–1.45), and 1.62 (1.31–2.01), respectively, in multivariable cause-specific hazard model. This association was more evident in analysis with time-updated SBP, where the corresponding HRs (95% CIs) were 1.30 (1.04–1.62), 1.35 (1.07–1.70), and 2.07 (1.67–2.57), respectively. Furthermore, the slopes of eGFR decline were -2.57 (-2.92 to -2.23), -2.62 (-3.00 to -2.25), -3.02 (-3.37 to -2.67), and -3.42 (-3.99 to -2.84) for respective SBP categories. Additional analyses with DBP also showed similar results. Conclusions: In patients with advanced CKD, higher BP levels were associated with increased risk of CKD progression.
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