Intensive BP control lacks benefit in chronic kidney disease

(HealthDay)—Intensive blood pressure (BP) control may provide no benefit and may even be harmful for patients with moderate-to-advanced chronic kidney disease, according to a study published online Oct. 16 in the Journal of Internal Medicine.

Yoshitsugu Obi, Ph.D., from the University of California Irvine Medical Center, and colleagues conducted post-hoc analysis of the Systolic Blood Pressure Intervention Trial to determine the risk-benefit profile of intensive BP control across estimated glomerular filtration rate (eGFR) levels.

The researchers found that the cardiovascular benefit from intensive treatment was diminished with lower eGFR (P interaction = 0.019), while eGFR did not alter the adverse effect on acute kidney injury (AKI; P interaction = 0.179). For the 891 participants with eGFR <45 mL/min/1.73 m², intensive treatment did not reduce the cardiovascular outcome (hazard ratio [HR], 0.92; 95 percent confidence interval, 0.62 to 1.38), while it increased AKI (HR, 1.73; 95 percent confidence interval, 1.12 to 2.66).

"Intensive BP control may provide little or no benefit and even be harmful for patients with moderate-to-advanced chronic kidney disease," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.