Trial reportJournal of the American Society of Nephrology : JASN2018
Acute Declines in Renal Function during Intensive BP Lowering and Long-Term Risk of Death.
Trial report in Journal of the American Society of Nephrology : JASN, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.
- Higher blood pressure targets for hypertension in older adults.The Cochrane database of systematic reviews · 2024Pooled it
- Association of baseline eGFR and incident heart failure on patients receiving intensive blood pressure treatment.ESC heart failure · 2025Trial
- Acute Declines in Estimated Glomerular Filtration Rate in Patients Treated With Benazepril and Hydrochlorothiazide Versus Amlodipine and Risk of Cardiovascular Outcomes.Journal of the American Heart Association · 2024Trial
- Risk of Kidney Impairment during Iguratimod Therapy for Rheumatoid Arthritis Patients: The Role of Concomitant Salazosulfapyridine.Internal medicine (Tokyo, Japan) · 2026Article
- Acute Declines in Estimated GFR in Blood Pressure Target Trials and Risk of Adverse Outcomes.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2023Observational
- Intensive BP Control and eGFR Declines: Are These Events Due to Hemodynamic Effects and Are Changes Reversible?Current cardiology reports · 2020Review
- Initial Estimated Glomerular Filtration Rate Decline and Long-Term Renal Function During Intensive Antihypertensive Therapy: A Post Hoc Analysis of the SPRINT and ACCORD-BP Randomized Controlled Trials.Hypertension (Dallas, Tex. : 1979) · 2020Article
- Incidence and Prognosis of Acute Kidney Diseases and Disorders Using an Integrated Approach to Laboratory Measurements in a Universal Health Care System.JAMA network open · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 7 institutions in 2 countries.
Funding
Abstract
backgroundDuring intensive BP lowering, acute declines in renal function are common, thought to be hemodynamic, and potentially reversible. We previously showed that acute declines in renal function ≥20% during intensive BP lowering were associated with higher risk of ESRD. Here, we determined whether acute declines in renal function during intensive BP lowering were associated with mortality risk among 1660 participants of the African American Study of Kidney Disease and Hypertension and the Modification of Diet in Renal Disease Trial.
methodsWe used Cox models to examine the association between percentage decline in eGFR (<5%, 5% to <20%, or ≥20%) between randomization and months 3-4 of the trials (period of therapy intensification) and death.
resultsIn adjusted analyses, compared with a <5% eGFR decline in the usual BP arm (reference), a 5% to <20% eGFR decline in the intensive BP arm was associated with a survival benefit (hazard ratio [HR], 0.77; 95% confidence interval [95% CI], 0.62 to 0.96), but a 5% to <20% eGFR decline in the usual BP arm was not (HR, 1.01; 95% CI, 0.81 to 1.26;
conclusionsIntensive BP lowering was associated with a mortality benefit only if declines in eGFR were <20%.
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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.