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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 CRIC and KNOW-CKD Study
저자	Cheol Ho Park
출판정보	2025; 2025(1):
키워드	Blood pressure, Hypertension, Chronic kidney disease, Severely impaired kidney function
초록	Blood pressure (BP) control is important in the management of chronic kidney disease (CKD). However, in patients with advanced CKD, the benefits of BP control in delaying the progression of CKD remains uncertain. We analyzed 2,939 participants with chronic kidney disease (CKD) G3b to G5 (estimated glomerular filtration rate [eGFR] <45 ml/min/1.73 m2) without kidney replacement therapy (KRT) from the Chronic Renal Insufficiency Cohort (CRIC) study and the KoreaN Cohort Study for Outcome in Patients With Chronic Kidney Disease (KNOW-CKD). 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 KRT. In the analyses, multivariate cause-specific hazards models and marginal structural models were fitted for baseline and time-updated BPs, respectively. During 17,755 person-years of follow-up (median, 4.7 years), the composite outcome occurred 1,627 (55.4%) participants. Compared with baseline SBP <120 mmHg, the hazard ratios (HRs) (95% CIs) for 120–129, 130–139, and ≥140 mmHg were 1.33 (1.15–1.54), 1.48 (1.27–1.72), and 1.82 (1.58–2.10), respectively. This association was more evident in analysis with time-updated SBP, where the corresponding HRs (95% CIs) were 1.29 (1.09–1.54), 1.75 (1.46–2.10), and 2.79 (2.36–3.29), respectively. Furthermore, the slopes of eGFR decline were -1.20 (-1.36 to -1.04), -1.77 (-1.97 to -1.57), -2.11 (-2.35 to -1.88), and -2.48 (-2.70 to -2.27) mL/min/1.73 m2 per year for respective SBP categories. Additional analyses with DBP also showed similar results. In patients with advanced CKD, higher BP levels were associated with an increased risk of CKD progression.
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