An analysis of the Systolic Blood Pressure Intervention Trial (SPRINT) indicates that nearly all adults with chronic kidney disease (CKD) would have benefits that outweigh the harm from\u00a0a systolic blood pressure target of\u00a0<120\u00a0mm\u00a0Hg\u00a0compared\u00a0with\u00a0a\u00a0target\u00a0of\u00a0<140\u00a0mm\u00a0Hg.\u00a0Thefindings\u00a0will\u00a0be\u00a0presented\u00a0at ASN Kidney Week 2025 November\u00a05\u2013 9.<\/p>\n
In a benefit-harm trade-off analysis of 2,012 participants with CKD, investigators found that\u00a0when\u00a0predicting\u00a0individualized\u00a0treatment\u00a0effects\u00a0for\u00a0multiple\u00a0outcomesand\u00a0simulating preferences for participants who view the benefits of intensive blood pressure lowering (reductions in death, cardiovascular events, and cognitive impairment) as much more important than treatment-related harms (such as emergency room visits or hospitalizations for acute kidney injury and fainting), 100% had a positive net benefit favoring intensive blood pressure lowering. When simulating benefits and harms to have similar, intermediate importance, 9 out of 10 still had a positive net benefit.<\/p>\n
Compared\u00a0with\u00a0people\u00a0with\u00a0earlier-stage\u00a0CKD\u00a0(estimated\u00a0glomerular\u00a0filtration\u00a0rate(45\u201359 ml\/min\/1.73m2), people with more advanced CKD (20\u201344 ml\/min\/1.73m2) experienced more treatment-related harms from a lower systolic blood pressure goal; however, they also had larger benefits, which resulted in the more advanced CKD group having greater net benefits. The findings, which are consistent with KDIGO Guidelines that recommend a systolic blood pressure target of <120 mm Hg for adults with hypertension and\u00a0CKD,\u00a0could\u00a0help\u00a0patients\u00a0and\u00a0care\u00a0partnersovercome\u00a0therapeutic\u00a0inertia\u00a0that\u00a0commonly\u00a0occurs\u00a0with intensifying blood pressure control in adults with CKD.<\/p>\n
<\/p>\n
This study demonstrates that evidence about blood pressure targets from SPRINT can be personalized to adults with hypertension and CKD by using each\u00a0individual’s\u00a0estimated\u00a0risks\u00a0and\u00a0preferences\u00a0for\u00a0multiple\u00a0outcomes\u00a0related\u00a0to\u00a0bloodpressure\u00a0lowering, which could help facilitate shared decision-making conversations.”<\/p>\n
\n
<\/p>\n
Alan Vera, Medical Student, University of California Davis<\/p>\n
<\/p>\n
Source:<\/p>\n
American Society of Nephrology<\/a><\/p>\n Journal reference:<\/p>\n