Evidence map›Paper›PMID 25493952›Full record

Trial reportKidney international2015

Association between strict blood pressure control during chronic kidney disease and lower mortality after onset of end-stage renal disease.

Elaine Ku, David V Glidden, Kirsten L Johansen, Mark Sarnak, Hocine Tighiouart, Barbara Grimes, Chi-Yuan Hsu

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Kidney international, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
46citing papers in PubMed, 7 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

46 citing papers in PubMed, 7 syntheses or guidelines pooled it.

  1. Pooled it
  2. Education programmes for people with chronic kidney disease and diabetes.The Cochrane database of systematic reviews · 2024
    Pooled it
  3. Pooled it
  4. Low protein diets for non-diabetic adults with chronic kidney disease.The Cochrane database of systematic reviews · 2020
    Pooled it
  5. Low protein diets for non-diabetic adults with chronic kidney disease.The Cochrane database of systematic reviews · 2018
    Pooled it
  6. Pooled it
  7. Clinical significance of 'cardiometabolic memory': a systematic review of randomized controlled trials.Hypertension research : official journal of the Japanese Society of Hypertension · 2017
    Pooled it
  8. Trial
  9. Trial
  10. Trial
  11. Acute Declines in Renal Function during Intensive BP Lowering and Long-Term Risk of Death.Journal of the American Society of Nephrology : JASN · 2018
    Trial
  12. Renal blood flow and progression to kidney failure in ADPKD.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2026
    Observational
  13. Review
  14. Impact of intensive blood pressure control on kidney outcomes.Current opinion in nephrology and hypertension · 2025
    Review
  15. Article
  16. Article
  17. Article
  18. Article
  19. The Nephroprotective Potential ofFoods (Basel, Switzerland) · 2023
    Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Elaine Ku1] Division of Nephrology, Department of Medicine, University of California, San Francisco, California, USA [2] Division of Pediatric Nephrology, Department of Pediatrics, University of California, San Francisco, California, USA.
David V GliddenDepartment of Biostatistics and Epidemiology, University of California, San Francisco, San Francisco, California, USA.
Kirsten L JohansenDivision of Nephrology, Department of Medicine, University of California, San Francisco, California, USA.
Mark SarnakDivision of Nephrology, Department of Medicine, Tufts Medical Center, Boston, Massachusetts, USA.
Hocine TighiouartTufts Medical Center, Institute for Clinical Research and Health Policy Studies, Research Design Center/Biostatistics Research Center, Boston, Massachusetts, USA.
Barbara GrimesDepartment of Biostatistics and Epidemiology, University of California, San Francisco, San Francisco, California, USA.
Chi-Yuan HsuDivision of Nephrology, Department of Medicine, University of California, San Francisco, California, USA.

Funding

Prevalence and Impact of Frailty among Dialysis PatientsK24DK085153 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI JOHANSEN, KIRSTEN L. · 2010 to 2021
$1.5M
Patient Oriented Research in Kidney DiseaseK24DK092291 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI HSU, CHI-YUAN · 2011 to 2020
$1.2M
Chronic Kidney Disease, Vascular Disease and AgingK24DK078204 · NIDDK · TUFTS MEDICAL CENTER · PI SARNAK, MARK J · 2007 to 2011
$587k
NIDDK NIH HHS K24 DK078204NIDDK NIH HHS K24 DK085153NIDDK NIH HHS K24 DK092291NIDDK NIH HHS K24 DK78204NIDDK NIH HHS K24 DK85153NIDDK NIH HHS K24 DK92291NIDDK NIH HHS N01-DK-7-005
6 · The paper itself

Abstract

There is controversy regarding whether strict blood pressure control is indicated in chronic kidney disease (CKD) since the primary results of randomized controlled trials failed to show any impact on progression of kidney disease with this strategy. However, strict blood pressure control may have other beneficial effects beyond reducing the risk of end-stage renal disease (ESRD), such as lowering mortality after ESRD onset. The Modification of Diet in Renal Disease (MDRD) trial randomized 840 patients with CKD to strict (mean arterial pressure under 92 mm Hg) versus usual (mean arterial pressure under 107 mm Hg) blood pressure control between 1989 and 1993. Here we extended follow-up of study enrollees by linkage with United States Renal Data System and National Death Index to ascertain ESRD and vital status through 2010. Overall, 627 patients developed ESRD through 2010 with a median follow-up of 19.3 years. After ESRD onset, there were 142 deaths in the strict blood pressure arm and 182 deaths in the usual blood pressure arm (significant unadjusted hazard ratio for death was 0.72 (95% CI 0.58-0.89)). Overall, there were 212 deaths in the strict blood pressure control arm and 233 deaths in the usual arm (significant unadjusted hazard ratio for death 0.82 (95% CI 0.68-0.98)). Thus, although strict blood pressure control did not delay progression of CKD to ESRD, this strategy was associated with a lower risk of death after ESRD. Hence, long-term post-ESRD outcomes should be considered when formulating blood pressure targets for CKD.

Indexed as

Blood PressureAdultAgedAntihypertensive AgentsDiet, Protein-RestrictedFemaleFollow-Up StudiesHumansHypertensionMaleMiddle AgedRenal Insufficiency, ChronicUnited StatesAntihypertensive Agents

Identifiers

PMID25493952
PMCPMC4425599

What OpenQuestion holds

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Read underepoch 390

Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.