Blood pressure and age-related GFR decline in the general population

摘要: Hypertension is one of the most important causes end-stage renal disease, but it unclear whether elevated blood pressure (BP) also accelerates gradual decline in glomerular filtration rate (GFR) seen general population with increasing age. The reason may be that studies have considered only baseline BP and not effects changes BP, antihypertensive treatment other determinants GFR during follow-up. Additionally, use estimated from creatinine or cystatin C instead measurements biased results because influence non-GFR related confounders. We studied relationship between using time-varying variables a cohort representative as iohexol clearance. included 1594 subjects aged 50 to 62 years without diabetes, kidney-, cardiovascular disease Renal Iohexol-clearance Survey Tromso 6 (RENIS-T6). GFR, medication all adjustment were ascertained at baseline, follow-up after median observation time 5.6 years 1299 persons (81%). was analyzed linear mixed models. mean (standard deviation) 0.95 (2.23) mL/min/year. percentage hypertension (systolic BP ≥ 140 mmHg, diastolic BP ≥ 90 mmHg medication) increased 42 52% In multivariable adjusted models independent measured follow-up, higher systolic associated slower rates by 0.10 0.20 mL/min/year/10 mmHg, respectively (p < 0.05). association stronger on than others (p < 0.05 for interaction medication). medium-term, accelerated middle-aged population. medication, paradoxical decline. Studies even longer periods are needed evaluate ultimate effect kidney function.