TY - JOUR
T1 - Association of blood pressure with the start of renal replacement therapy in elderly compared with young patients receiving predialysis care
AU - PREPARE-1 Study Group
AU - de Goeij, Moniek C M
AU - de Jager, Dinanda J
AU - Grootendorst, Diana C
AU - Voormolen, Nora
AU - Sijpkens, Yvo W J
AU - van Dijk, Sandra
AU - Hoogeveen, Ellen K
AU - Kooman, Jeroen P
AU - Boeschoten, Elisabeth W
AU - Dekker, Friedo W
AU - Halbesma, Nynke
PY - 2012/11/1
Y1 - 2012/11/1
N2 - BACKGROUND: In the growing elderly predialysis population, little is known about the effect of identified risk factors on the progression to end-stage renal disease. Therefore, we investigated the association of systolic (SBP) and diastolic blood pressure (DBP) with the start of renal replacement therapy (RRT), in elderly (≥65 years) compared with young (<65 years) predialysis patients.METHODS: In the PREPARE-1 cohort, 547 incident predialysis patients, referred as part of the usual care to eight Dutch predialysis care outpatient clinics, were included (1999-2001) and followed until the start of dialysis, transplantation, death, or until 1 January 2008. The outcome was the start of RRT. All analyses were stratified for age; <65 years (young) and ≥65 years (elderly).RESULTS: In young predialysis patients (n = 268) higher SBP (every 20 mm Hg increase) and high DBP (DBP ≥100 mm Hg compared with 80-89 mm Hg) were associated with a higher rate of starting RRT (adjusted hazard ratio (HR) (95% confidence interval) 1.21 (1.09;1.34) and 1.74 (1.16;2.62), respectively). However, in elderly predialysis patients (n = 240) only patients with SBP ≥180 mm Hg had an increased rate compared with patients with 140-159 mm Hg (adjusted HR 2.33 (1.41;3.87)). Furthermore, patients with DBP <70 or ≥100 mm Hg had an increased rate of starting RRT, independent of SBP, compared with patients with 80-89 mm Hg (fully adjusted HR 1.72 (1.01;2.94) and 2.05 (1.13;3.73), respectively).CONCLUSIONS: The association of SBP and DBP with the start of RRT is different between elderly and young predialysis patients.
AB - BACKGROUND: In the growing elderly predialysis population, little is known about the effect of identified risk factors on the progression to end-stage renal disease. Therefore, we investigated the association of systolic (SBP) and diastolic blood pressure (DBP) with the start of renal replacement therapy (RRT), in elderly (≥65 years) compared with young (<65 years) predialysis patients.METHODS: In the PREPARE-1 cohort, 547 incident predialysis patients, referred as part of the usual care to eight Dutch predialysis care outpatient clinics, were included (1999-2001) and followed until the start of dialysis, transplantation, death, or until 1 January 2008. The outcome was the start of RRT. All analyses were stratified for age; <65 years (young) and ≥65 years (elderly).RESULTS: In young predialysis patients (n = 268) higher SBP (every 20 mm Hg increase) and high DBP (DBP ≥100 mm Hg compared with 80-89 mm Hg) were associated with a higher rate of starting RRT (adjusted hazard ratio (HR) (95% confidence interval) 1.21 (1.09;1.34) and 1.74 (1.16;2.62), respectively). However, in elderly predialysis patients (n = 240) only patients with SBP ≥180 mm Hg had an increased rate compared with patients with 140-159 mm Hg (adjusted HR 2.33 (1.41;3.87)). Furthermore, patients with DBP <70 or ≥100 mm Hg had an increased rate of starting RRT, independent of SBP, compared with patients with 80-89 mm Hg (fully adjusted HR 1.72 (1.01;2.94) and 2.05 (1.13;3.73), respectively).CONCLUSIONS: The association of SBP and DBP with the start of RRT is different between elderly and young predialysis patients.
KW - Adult
KW - Aged
KW - Antihypertensive Agents
KW - Blood Pressure
KW - Disease Progression
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Hypertension
KW - Kidney Failure, Chronic
KW - Male
KW - Middle Aged
KW - Renal Replacement Therapy
U2 - 10.1038/ajh.2012.100
DO - 10.1038/ajh.2012.100
M3 - Article
C2 - 22810845
SN - 0895-7061
VL - 25
SP - 1175
EP - 1181
JO - American Journal of Hypertension
JF - American Journal of Hypertension
IS - 11
ER -