Association of blood pressure with decline in renal function and time until the start of renal replacement therapy in pre-dialysis patients: a cohort study

Table 3 Association of systolic and diastolic blood pressure with decline in renal function during the first year of pre-dialysis care

	n	Baseline eGFR* (ml/min/ 1.73 m²)	Crude additional decline (ml/min/ 1.73 m²/month)	Adjusted additional decline^† (ml/min/ 1.73 m²/month)	Adjusted additional decline^‡ (ml/min/ 1.73 m²/month)
Systolic blood pressure (mmHg):
Per 10	436		0.03 (0.01;0.06)	0.04 (0.02;0.07)	0.04 (0.02;0.07)
< 130	79	14.0	0^§	0	0
130-149	116	12.8	0.13 (-0.09;0.34)	0.15 (-0.06;0.36)	0.14 (-0.07;0.35)
150-169	125	12.7	0.14 (-0.08;0.35)	0.19 (-0.02;0.39)	0.17 (-0.04;0.38)
170-189	72	14.2	0.19 (-0.05;0.43)	0.27 (0.04;0.51)	0.24 (0.00;0.48)
≥ 190	44	13.3	0.34 (0.06;0.61)	0.44 (0.16;0.71)	0.43 (0.15;0.70)
Diastolic blood pressure (mmHg):
Per 10	436		0.07 (0.02;0.12)	0.05 (0.00;0.10)	0.05 (0.00;0.11)
< 80	122	13.4	0^γ	0	0
80-89	151	13.7	0.08 (-0.10;0.26)	0.06 (-0.12;0.23)	0.07 (-0.11;0.25)
90-99	98	13.3	0.12 (-0.07;0.32)	0.12 (-0.08;0.31)	0.12 (-0.08;0.32)
≥ 100	65	11.9	0.29 (0.07;0.52)	0.23 (0.00;0.45)	0.22 (-0.01;0.44)
Blood pressure treatment target goal (mmHg):
< 130/< 80	47	14.2	0^	0	0
≥ 130/< 80	75	13.0	0.21 (-0.07;0.48)	0.31 (0.04;0.58)	0.31 (0.04;0.58)
< 130/≥ 80	32	13.8	0.22 (-0.12;0.55)	0.21 (-0.12;0.54)	0.26 (-0.08;0.59)
≥ 130/≥ 80	282	13.1	0.27 (0.04;0.50)	0.30 (0.08;0.53)	0.31 (0.08;0.53)

The decline (95% confidence interval) presented for each blood pressure category indicates the additional decline in renal function compared to the reference category (systolic blood pressure (SBP) < 130 mmHg, diastolic blood pressure (DBP) < 80 mmHg, and SBP/DBP < 130/< 80 mmHg). A negative decline is equivalent to a slower decline in renal function.
* The mean estimated glomerular filtration rate (eGFR) in ml/min/1.73 m² at baseline. ^† Adjusted for sex and age. ^‡ Adjusted for sex, age, race, smoking, primary kidney disease, and the co-morbidities cardiovascular disease (CVD) and diabetes mellitus (DM). ^§ The mean (standard deviation, SD) decline in renal function is 0.22 (0.74) ml/min/1.73 m²/month. ^γ The mean (SD) decline in renal function is 0.26 (0.90) ml/min/1.73 m²/month. ^The mean (SD) decline in renal function is 0.13 (0.85) ml/min/1.73 m²/month.

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