Effect of Blood Pressure Lowering and Antihypertensive Drug Class on Progression of Hypertensive Kidney Disease<SUBTITLE>Results From the AASK Trial</SUBTITLE>

Abstract

No additional benefit of slowing progression of hypertensive nephrosclerosis was observed with the lower BP goal. Angiotensin-converting enzyme inhibitors appear to be more effective than beta-blockers or dihydropyridine calcium channel blockers in slowing GFR decline.

Association of blood pressure with decline in renal function and time until the start of renal replacement therapy in pre-dialysis patients: a cohort study

“…Our data are not in line with some previous published interventional trials on the effect of lowering blood pressure in CKD patients [27-29]. These studies showed that in patients with CKD stages III-V intensive blood pressure lowering (< 130/80 mmHg versus < 140/90 mmHg) was not beneficial on the progression of CKD, defined as decline in renal function or time until the start of dialysis, transplantation, death and/or doubling of serum creatinine.…”

Association between strict blood pressure control during chronic kidney disease and lower mortality after onset of end-stage renal disease

“…Our long-term follow-up results regarding reno-protection are consistent with the results of the original MDRD trial and other randomized controlled trials of strict BP control in CKD, including AASK and REIN-2, all of which showed no benefit of strict BP control in retarding progression towards ESRD. 13 , 14 We also found no difference in deaths prior to ESRD onset, which is in agreement with the results of previous studies. 13 , 15 Our results differ from those of a previous analysis of risk of ESRD and death (prior to ESRD) among MDRD participants during extended follow-up through the end of 2000, but our current study incorporates significantly more follow-up time.…”

“… 13 , 14 We also found no difference in deaths prior to ESRD onset, which is in agreement with the results of previous studies. 13 , 15 Our results differ from those of a previous analysis of risk of ESRD and death (prior to ESRD) among MDRD participants during extended follow-up through the end of 2000, but our current study incorporates significantly more follow-up time. 15 The main feature that distinguishes the current analysis from prior literature is the innovative focus on risk of death post-ESRD.…”

Uraemia Progression in Chronic Kidney Disease Stages 3–5 Is Not Constant

“…intensive antihypertensive treatment, better calcium and phosphate control, increased use of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, have altered average ΔGFR. Males had a faster progression than females in accordance with previous studies [20,21,22]. …”