Associations of Systolic Blood Pressure With Incident CKD G3-G5: A Cohort Study of South Korean Adults.

Published on Apr 15, 2020in American Journal of Kidney Diseases6.653
· DOI :10.1053/J.AJKD.2020.01.013
Tae Ik Chang12
Estimated H-index: 12
Hyunsun Lim1
Estimated H-index: 1
+ 6 AuthorsSeung Hyeok Han32
Estimated H-index: 32
(Yonsei University)
Rationale & Objective Clinical practice guidelines recommend a target blood pressure (BP) Study Design Population-based retrospective cohort study. Setting & Participants 10.5 million adults who participated in the National Health Insurance Service National Health Checkup Program in South Korea between 2009 and 2015 and had an estimated glomerular filtration rate (GFR) ≥ 60 mL/min/1.73 m2 at the beginning of follow-up. Predictors Baseline and time-updated systolic BP (SBP) as a continuous variable and categorized as Outcome Incident CKD GFR categories 3 to 5 (CKD G3-G5), defined as de novo development of estimated GFR Analytical Approach Cox proportional hazards regression for baseline BP and marginal structural analysis for time-updated BP. Results During 49,169,311 person-years of follow-up, incident CKD G3-G5 developed in 172,423 (1.64%) individuals with a crude event rate of 3.51 (95% CI, 3.49-3.52) per 1,000 person-years. Compared to a baseline SBP of 120 to 129 mm Hg, HRs for incident CKD G3-G5 for the Limitations Use of International Classification of Diseases codes to assess comorbid condition burden; residual confounding, and potential selection bias cannot be excluded. Conclusions In this large national cohort study, higher SBPs were associated with higher risk for incident CKD G3-G5. These findings support evaluation of SBP-lowering strategies to reduce the development of CKD.
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