Evidence map›Paper›PMID 40759824›Full record

ArticleClinical and experimental nephrology2025

Blood pressure load associated with progressive kidney function decline in biopsy-proven atherosclerotic chronic kidney disease patients.

Hiroki Nobayashi, Go Kanzaki, Haruki Mae, Kotaro Haruhara, Nobuo Tsuboi, Takashi Yokoo

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Article in Clinical and experimental nephrology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Hiroki NobayashiDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-Ku, Tokyo, 105-8461, Japan.
Go KanzakiDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-Ku, Tokyo, 105-8461, Japan. g-kanzaki@jikei.ac.jp.ORCID http://orcid.org/0000-0002-7795-369X
Haruki MaeDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-Ku, Tokyo, 105-8461, Japan.
Kotaro HaruharaDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-Ku, Tokyo, 105-8461, Japan.
Nobuo TsuboiDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-Ku, Tokyo, 105-8461, Japan.
Takashi YokooDivision of Nephrology and Hypertension, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato-Ku, Tokyo, 105-8461, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHypertension is a major risk factor for the progression of chronic kidney disease (CKD). However, the impact of blood pressure (BP) load, especially when office BP is normal, remains unclear. Thus, we conducted a retrospective cohort study to elucidate the impact of elevated BP load in patients with biopsy-proven CKD, BP load elevation, and a normal office BP compared with normotensive patients with CKD but without BP load elevation and those with hypertension.

methodsWe retrospectively analyzed patients with histologically confirmed atherosclerotic CKD who underwent kidney biopsy and 24-h ambulatory BP monitoring (ABPM). Patients were classified into normotension, isolated BP load elevation, and hypertension groups. The primary outcome was a ≥ 30% sustained decline in estimated glomerular filtration rate (eGFR) within 3 years.

resultsA total of 57 patients were analyzed. The isolated BP load elevation and hypertension groups showed a significantly higher incidence of adverse kidney events than the normotension group (p < 0.01). After adjusting for confounding factors (age, sex, urinary protein, and Mayo Clinic Chronicity Score), the hazard for kidney outcomes remained significant in the isolated BP load elevation group (hazard ratio, 9.25; 95% confidence interval, 1.29-66.30).

conclusionsIsolated BP load elevation is a significant risk factor for CKD progression even in patients with normal office BP. Normalization of BP load may be a potential therapeutic target in patients with CKD. Comprehensive BP assessment using 24-h ABPM is crucial for CKD management, as it reveals clinically important abnormalities that conventional measurements may not capture.

Indexed as

AtherosclerosisBlood PressureHypertensionKidneyRenal Insufficiency, ChronicAdultAgedBiopsyBlood Pressure Monitoring, AmbulatoryDisease ProgressionFemaleGlomerular Filtration RateHumansMaleMiddle AgedRetrospective StudiesAmbulatory blood pressure monitoringArteriosclerosisBlood pressure loadChronic kidney diseaseHypertensionKidney biopsy

Identifiers

PMID40759824

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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.