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An upward revision of the blood pressure numbers used to identifyrisk of end-stage renal disease (ESRD) might actually help doctorsprovide better care for their patients, said the authors of a studyin patients with chronic kidney disease (CKD). The researchers found that systolic blood pressure - the "uppernumber" in a blood pressure reading - was the key variable. Currentguidelines call for CKD patients to maintain a systolic pressure of130/80 or lower in order to prevent ESRD, which is complete oralmost complete kidney failure, leading to dialysis, kidneytransplant, or death. In the study, however, the team determined that systolic pressurehad to be 140 or higher in order to be associated with an increasedrisk of ESRD. A level of 150 or higher was associated with highestrisk. Given that attaining a systolic blood pressure of 130/80 is "veryhard to achieve among patients in clinical practice," it would beworth considering revising the guidelines to make them "a bit morelenient and easier to achieve," said lead author Carmen A. Peralta,MD, a physician at the San Francisco VA Medical Center (SFVAMC) andan assistant professor of medicine at the University of California,San Francisco (UCSF). "A revision might allow physicians to not only prescribe fewerblood pressure medications for their patients, but focus moreclearly on other aspects of their care, such as blood glucoselevels in diabetics," said Peralta. The researchers also found, to their surprise, that more than onethird of patients in the study had uncontrolled hypertension - defined as a blood pressure of 150/90 or higher - which greatlyincreases the risk of cardiovascular disease as well as ESRD. Thegreatest risk factors were being age 60 or older and having highlevels of protein in urine. "The prevalence of hypertension indicates a serious public healthconcern in the United States," said Peralta, "and tells us that weneed to do a lot more education on the importance of blood pressurecontrol. It also tells us that perhaps our efforts should befocused on reducing blood pressure among people at highest risk,rather than chasing lower numbers in individuals already at140/90." Peralta said that the study, published in the Archives of General Internal Medicine, is particularly important because it examined the link betweenblood pressure and risk of ESRD under "real world" conditions in a"contemporary, representative sample" of patients with kidneydisease. She and her fellow researchers studied 16,129 participants in theKidney Early Evaluation Program (KEEP), a nationwide kidney healthscreening program offered by the National Kidney Foundation. "TheKEEP cohort is a realistic representation of regular people in theUnited States walking around with CKD," said Peralta. "In the past,the question of what targets we should establish for preventingESRD has mostly been studied in randomized control trials, whereparticipants actually tend to be healthier than the generalpopulation." All study participants had stage 3 CKD, defined as an estimatedglomerular filtration rate (eGFR) of lower than 60. GFR is the flowrate of blood filtered by the kidney. Additional References Citations. I am an expert from shineder-lace.com, while we provides the quality product, such as Eyelet Lace Manufacturer , China Beaded Lace Fabric, Brushed Lace,and more.
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