Blood pressure targets in patients with chronic kidney disease: MDRD and AASK now confirming SPRINT

Clinical Kidney Journal
Pantelis SarafidisLuis M Ruilope

Abstract

Recent American and European hypertension guidelines are not in agreement regarding blood pressure (BP) targets for persons with chronic kidney disease (CKD). Previous analyses from the African American Study on Kidney Disease (AASK) and Modification of Diet in Renal Disease (MDRD) trials suggested that strict BP control confers nephroprotection for patients with proteinuria, but a mortality benefit was not apparent. In contrast, an analysis of the Systolic Blood Pressure Intervention Trial (SPRINT) subpopulation of CKD patients showed a mortality benefit with the systolic blood pressure (SBP) <120 mmHg versus the SBP <140 target. A recent analysis of the combined MDRD and AASK cohorts supports previous evidence on nephroprotection but also findings from the SPRINT trial on all-cause mortality benefits of intensive versus usual BP control in individuals with CKD.

References

Nov 21, 2002·JAMA : the Journal of the American Medical Association·Jackson T WrightUNKNOWN African American Study of Kidney Disease and Hypertension Study Group
Apr 1, 2008·The American Journal of Medicine·Pantelis A SarafidisGeorge L Bakris
Sep 8, 2010·The New England Journal of Medicine·Lawrence J AppelUNKNOWN AASK Collaborative Research Group
Nov 10, 2015·The New England Journal of Medicine·UNKNOWN SPRINT Research GroupWalter T Ambrosius
Jan 21, 2017·Nature Reviews. Endocrinology·Pantelis A SarafidisLuis M Ruilope
Jun 24, 2017·Journal of the American Society of Nephrology : JASN·Alfred K CheungUNKNOWN SPRINT Research Group
Dec 7, 2019·Clinical Kidney Journal·Esmeralda Castillo-RodriguezAlberto Ortiz

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