Systolic blood pressure is the first, or top, number in your blood pressure reading. It is the highest level your blood pressure reaches when your heart beats. If you have chronic kidney disease (CKD), your doctor may recommend a standard systolic blood pressure target between 135 to 139 mm Hg. New research indicates that more intensive blood pressure control could help reduce the risk of needing kidney replacement therapy (KRT), such as dialysis, in patients with advanced CKD. Learn what researchers did, what they found, and what it means.* 

What the researchers did

Gathering data from seven different studies, the researchers compared intensive systolic blood pressure control (resulting in less than 120 mm Hg) to standard blood pressure control in 5,823 CKD patients, all with an estimated glomerular filtration rate (eGFR), or remaining kidney function, of less than 60. 

What they found

Of those patients, 1,089 (22%) had advanced (stage 4 or 5) CKD and 4,744 had stage 3. In those with advanced CKD, there was a 19% decreased risk of kidney failure requiring KRT in patients with intensive blood pressure control. On the other hand, stage 3 CKD patients did not show any benefit with improved blood pressure control. 

What it means 

The latest blood pressure guidelines from the organization Kidney Disease Improving Global Outcomes (KDIGO) recommend that all CKD patients have a systolic blood pressure less than 120 mm Hg, however data for advanced CKD patients was lacking. 

The research team says that their findings could help advanced CKD patients reach KDIGO’s target, and that more clinical trials should be conducted in order to confirm the findings and ensure there is no additional health risk to this vulnerable population. 

*Persaud, N. (2023b, January 23). Intensive Blood Pressure Control May Delay Progression in Advanced CKD. Renal and Urology News. https://www.renalandurologynews.com/home/news/nephrology/chronic-kidney-disease-ckd/intensive-blood-pressure-control-may-delay-progression-in-advanced-ckd/