| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Hypertension. 1995;25:587-594.)
© 1995 American Heart Association, Inc.
Articles |
Early Predictors of 15-Year End-Stage Renal Disease in Hypertensive Patients
From the Department of Veterans Affairs Medical Center and the Washington University School of Medicine, Division of Hypertension (H.M.P., S.E.C.), and the Washington University School of Medicine, Division of Biostatistics (J.P.M., J.R.F., J.D.B.), St Louis, Mo; the Department of Veterans Affairs Medical Center Sepulveda, Calif (M.P.S.), Memphis, Tenn (G.R.), and St Louis, Mo (D.W.M.).
Correspondence to H. Mitchell Perry, Jr, MD, DVA Medical Center (111DJC), 915 N Grand Blvd, St Louis, MO 63106.
Abstract There has been a continuing increase in the incidence of end-stage renal disease (ESRD) in the United States, including the fraction that has been attributed to hypertension. This study was done to seek relationships between ESRD and pretreatment clinical data and between ESRD and early treated blood pressure data in a population of hypertensive veterans. We identified a total of 5730 black and 6182 nonblack male veterans as hypertensive from 1974 through 1976 in 32 Veterans Administration Hypertension Screening and Treatment Program clinics. Their mean age was 52.5±10.2 years, and their mean pretreatment blood pressure was 154.3±19.0/100.8±9.8 mm Hg. During a minimum of 13.9 years of follow-up, 5337 (44.8%) of these patients died and 245 developed ESRD. For 1055 of these subjects, pretreatment systolic blood pressure (SBP) was greater than 180 mm Hg; 901 were diabetic; 1471 had a history of urinary tract problems; and 2358 of the 9644 who were treated had an early fall in SBP of more than 20 mm Hg. We used proportional hazards modeling to fit multivariate survival models to determine the effect of the available pretreatment data and early treated blood pressure levels on ESRD. This model demonstrated the independent increased risk of ESRD associated with being black or diabetic (risk ratio, 2.2 or 1.8), having a history of urinary tract problems (risk ratio, 2.2), or having high pretreatment SBP (for SBP 165 to 180 mm Hg, risk ratio was 2.8; for SBP >180 mm Hg, risk ratio was 7.6). In addition, myocardial infarction during follow-up increased the risk of subsequent ESRD almost twofold, and congestive heart failure increased it more than fivefold. The rate of ESRD in those whose SBP fell more than 20 mm Hg decreased by two thirds.
Key Words: hypertension, essential • veterans • kidney failure, chronic • epidemiologic factors
This article has been cited by other articles:
 |
|
 |
|
  C.-y. Hsu, C. Iribarren, C. E. McCulloch, J. Darbinian, and A. S. Go Risk Factors for End-Stage Renal Disease: 25-Year Follow-up Arch Intern Med, February 23, 2009; 169(4): 342 - 350. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Chonchol, H. Gnahn, and D. Sander Impact of subclinical carotid atherosclerosis on incident chronic kidney disease in the elderly Nephrol. Dial. Transplant., August 1, 2008; 23(8): 2593 - 2598. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. S. Schaeffner, T. Kurth, T. S. Bowman, R. P. Gelber, and J. M. Gaziano Blood pressure measures and risk of chronic kidney disease in men Nephrol. Dial. Transplant., April 1, 2008; 23(4): 1246 - 1251. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. R. Orth and S. I. Hallan Smoking: A Risk Factor for Progression of Chronic Kidney Disease and for Cardiovascular Morbidity and Mortality in Renal Patients Absence of Evidence or Evidence of Absence? Clin. J. Am. Soc. Nephrol., January 1, 2008; 3(1): 226 - 236. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. E. O'Neil and T. A. Nicklas State of the Art Reviews: Relationship Between Diet/ Physical Activity and Health American Journal of Lifestyle Medicine, December 1, 2007; 1(6): 457 - 481. [Abstract] [PDF]
|
|
|
|
 |
|
 T. Ninomiya, M. Kubo, Y. Doi, K. Yonemoto, Y. Tanizaki, K. Tsuruya, K. Sueishi, M. Tsuneyoshi, M. Iida, and Y. Kiyohara Prehypertension Increases the Risk for Renal Arteriosclerosis in Autopsies: The Hisayama Study J. Am. Soc. Nephrol., July 1, 2007; 18(7): 2135 - 2142. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Reynolds, D. Gu, P. Muntner, J. W. Kusek, J. Chen, X. Wu, X. Duan, C.-S. Chen, M. J. Klag, P. K. Whelton, et al. A Population-Based, Prospective Study of Blood Pressure and Risk for End-Stage Renal Disease in China J. Am. Soc. Nephrol., June 1, 2007; 18(6): 1928 - 1935. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. Dasgupta, C. Porter, A. Innes, and R. Burden 'Benign' hypertensive nephrosclerosis QJM, February 1, 2007; 100(2): 113 - 119. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. J. L. Bakker, R. T. Gansevoort, and D. de Zeeuw Metabolic syndrome: a fata morgana? Nephrol. Dial. Transplant., January 1, 2007; 22(1): 15 - 20. [Full Text] [PDF]
|
|
|
|
|
|
C.-y. Hsu, A. S. Go, C. E. McCulloch, J. Darbinian, and C. Iribarren Exploring Secular Trends in the Likelihood of Receiving Treatment for End-Stage Renal Disease Clin. J. Am. Soc. Nephrol., January 1, 2007; 2(1): 81 - 88. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. I. Parikh, S.-J. Hwang, M. G. Larson, J. B. Meigs, D. Levy, and C. S. Fox Cardiovascular disease risk factors in chronic kidney disease: overall burden and rates of treatment and control. Arch Intern Med, September 25, 2006; 166(17): 1884 - 1891. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Ishani, G. A. Grandits, R. H. Grimm, K. H. Svendsen, A. J. Collins, R. J. Prineas, J. D. Neaton, and for the MRFIT Research Group Association of Single Measurements of Dipstick Proteinuria, Estimated Glomerular Filtration Rate, and Hematocrit with 25-Year Incidence of End-Stage Renal Disease in the Multiple Risk Factor Intervention Trial J. Am. Soc. Nephrol., May 1, 2006; 17(5): 1444 - 1452. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C.-y. Hsu, C. E. McCulloch, C. Iribarren, J. Darbinian, and A. S. Go Body Mass Index and Risk for End-Stage Renal Disease Ann Intern Med, January 3, 2006; 144(1): 21 - 28. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. CY, M. CE, D. J, G. AS, I. C, T. E, C. HC, L. M, R. S, R. ER, et al. Which Comes First--Renal Dysfunction or High Blood Pressure?: Elevated Blood Pressure and Risk of End-Stage Renal Disease in Subjects without Baseline Kidney Disease. Arch Intern Med 165: 923-928, 2005 J. Am. Soc. Nephrol., October 1, 2005; 16(10): 2817 - 2820. [Full Text] [PDF]
|
|
|
|
 |
|
 W.-Z. Ying and P. W. Sanders Enhanced expression of EGF receptor in a model of salt-sensitive hypertension Am J Physiol Renal Physiol, August 1, 2005; 289(2): F314 - F321. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. J. Johnson, M. S. Segal, T. Srinivas, A. Ejaz, W. Mu, C. Roncal, L. G. Sanchez-Lozada, M. Gersch, B. Rodriguez-Iturbe, D.-H. Kang, et al. Essential Hypertension, Progressive Renal Disease, and Uric Acid: A Pathogenetic Link? J. Am. Soc. Nephrol., July 1, 2005; 16(7): 1909 - 1919. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C.-y. Hsu, C. E. McCulloch, J. Darbinian, A. S. Go, and C. Iribarren Elevated Blood Pressure and Risk of End-stage Renal Disease in Subjects Without Baseline Kidney Disease Arch Intern Med, April 25, 2005; 165(8): 923 - 928. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Ejerblad, C. M. Fored, P. Lindblad, J. Fryzek, P. W. Dickman, C.-G. Elinder, J. K. McLaughlin, and O. Nyren Association between Smoking and Chronic Renal Failure in a Nationwide Population-Based Case-Control Study J. Am. Soc. Nephrol., August 1, 2004; 15(8): 2178 - 2185. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. M. McClellan, R. D. Langston, and R. Presley Medicare Patients with Cardiovascular Disease Have a High Prevalence of Chronic Kidney Disease and a High Rate of Progression to End-Stage Renal Disease J. Am. Soc. Nephrol., July 1, 2004; 15(7): 1912 - 1919. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Abbott, E. Basta, and G. L. Bakris Blood Pressure Control and Nephroprotection in Diabetes J. Clin. Pharmacol., April 1, 2004; 44(4): 431 - 438. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. S. Fox, M. G. Larson, E. P. Leip, B. Culleton, P. W. F. Wilson, and D. Levy Predictors of New-Onset Kidney Disease in a Community-Based Population JAMA, February 18, 2004; 291(7): 844 - 850. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. R. Orth Effects of Smoking on Systemic and Intrarenal Hemodynamics: Influence on Renal Function J. Am. Soc. Nephrol., January 1, 2004; 15(90010): S58 - 63. [Abstract] [Full Text]
|
|
|
|
|
|
M. K. Haroun, B. G. Jaar, S. C. Hoffman, G. W. Comstock, M. J. Klag, and J. Coresh Risk Factors for Chronic Kidney Disease: A Prospective Study of 23,534 Men and Women in Washington County, Maryland J. Am. Soc. Nephrol., November 1, 2003; 14(11): 2934 - 2941. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. L. Bakris, M. R. Weir, S. Shanifar, Z. Zhang, J. Douglas, D. J. van Dijk, and B. M. Brenner Effects of Blood Pressure Level on Progression of Diabetic Nephropathy: Results From the RENAAL Study Arch Intern Med, July 14, 2003; 163(13): 1555 - 1565. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Muntner, J. Coresh, N. R. Powe, and M. J. Klag The Contribution of Increased Diabetes Prevalence and Improved Myocardial Infarction and Stroke Survival to the Increase in Treated End-Stage Renal Disease J. Am. Soc. Nephrol., June 1, 2003; 14(6): 1568 - 1577. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Tozawa, K. Iseki, C. Iseki, K. Kinjo, Y. Ikemiya, and S. Takishita Blood Pressure Predicts Risk of Developing End-Stage Renal Disease in Men and Women Hypertension, June 1, 2003; 41(6): 1341 - 1345. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Iseki, Y. Ikemiya, C. Iseki, and S. Takishita Haematocrit and the risk of developing end-stage renal disease Nephrol. Dial. Transplant., May 1, 2003; 18(5): 899 - 905. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. E. Vikse, K. Aasarod, L. Bostad, and B. M. Iversen Clinical prognostic factors in biopsy-proven benign nephrosclerosis Nephrol. Dial. Transplant., March 1, 2003; 18(3): 517 - 523. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. R. Orth Smoking and the Kidney J. Am. Soc. Nephrol., June 1, 2002; 13(6): 1663 - 1672. [Full Text] [PDF]
|
|
|
|
 |
|
 D. S. Silverberg, D. Wexler, D. Sheps, M. Blum, G. Keren, R. Baruch, D. Schwartz, T. Yachnin, S. Steinbruch, I. Shapira, et al. The effect of correction of mild anemia in severe, resistant congestive heart failure using subcutaneous erythropoietin and intravenous iron: a randomized controlled study J. Am. Coll. Cardiol., June 1, 2001; 37(7): 1775 - 1780. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Coresh, G. L. Wei, G. McQuillan, F. L Brancati, A. S. Levey, C. Jones, and M. J. Klag Prevalence of High Blood Pressure and Elevated Serum Creatinine Level in the United States: Findings From the Third National Health and Nutrition Examination Survey (1988-1994) Arch Intern Med, May 14, 2001; 161(9): 1207 - 1216. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. C. Luft Hypertensive nephrosclerosis-a cause of end-stage renal disease? Nephrol. Dial. Transplant., October 1, 2000; 15(10): 1515 - 1517. [Full Text] [PDF]
|
|
|
|
|
|
W. J. Elliott, D. R. Weir, and H. R. Black Cost-effectiveness of the Lower Treatment Goal (of JNC VI) for Diabetic Hypertensive Patients Arch Intern Med, May 8, 2000; 160(9): 1277 - 1283. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. A. Kotchen, A. W. Piering, A. W. Cowley, C. E. Grim, D. Gaudet, P. Hamet, M. L. Kaldunski, J. M. Kotchen, and R. J. Roman Glomerular Hyperfiltration in Hypertensive African Americans Hypertension, March 1, 2000; 35(3): 822 - 826. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Maschio How good are nephrologists at controlling blood pressure in renal patients? Nephrol. Dial. Transplant., September 1, 1999; 14(9): 2075 - 2077. [Full Text] [PDF]
|
|
|
|
 |
|
 W F Clark and L M Moist Management of chronic renal insufficiency in lupus nephritis: Role of proteinuria, hypertension and dyslipidemia in the progression of renal disease Lupus, November 1, 1998; 7(9): 649 - 653. [Abstract] [PDF]
|
|
|
|
|
|
H. M. Perry Jr, S. Bingham, A. Horney, G. Rutan, M. Sambhi, S. Carmody, and J. Collins Antihypertensive Efficacy of Treatment Regimens Used in Veterans Administration Hypertension Clinics Hypertension, March 1, 1998; 31(3): 771 - 779. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
The Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure Arch Intern Med, November 24, 1997; 157(21): 2413 - 2446. [Abstract] [PDF]
|
|
|
|
|
|
M. J. Klag, P. K. Whelton, B. L. Randall, J. D. Neaton, F. L. Brancati, and J. Stamler End-stage Renal Disease in African-American and White Men: 16-Year MRFIT Findings JAMA, April 23, 1997; 277(16): 1293 - 1298. [Abstract] [PDF]
|
|
|
|
 |
|
 M. J. Klag, P. K. Whelton, B. L. Randall, J. D. Neaton, F. L. Brancati, C. E. Ford, N. B. Shulman, and J. Stamler Blood Pressure and End-Stage Renal Disease in Men N. Engl. J. Med., January 4, 1996; 334(1): 13 - 18. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Suthanthiran, B. Li, J. O. Song, R. Ding, V. K. Sharma, J. E. Schwartz, and P. August Transforming growth factor-beta 1 hyperexpression in African-American hypertensives: A novel mediator of hypertension and/or target organ damage PNAS, March 28, 2000; 97(7): 3479 - 3484. [Abstract] [Full Text] [PDF]
|
|