Charlotte Robinson

DocwireNews

When efforts at intensive blood pressure (BP) lowering are initiated for patients with advanced chronic kidney disease (CKD), there is a potential risk of acute kidney injury, hyperkalemia, and end-stage renal disease. Elaine Ku, MD,&#8239;and colleagues conducted a nonblinded, randomized, controlled pilot trial to help determine whether lower home systolic BP (SBP) targets can be safely achieved in patients with CKD through titration of BP medications using in-home&ndash;measured BP.&nbsp;The study examined 108 patients with advanced CKD (estimated glomerular filtration rate &le;30 mL/min/1.73 m2) and hypertension who were randomized to either a target SBP goal of less than 120 mm Hg (n=66) or a less intensive goal (n=42). Antihypertensive medications were titrated to achieve the target home SBP range within the first four months of the study. The medications were maintained through the end of the study period. A wireless Bluetooth-enabled monitor was used to measure home BP and transmit real-time readings to clinicians.&nbsp;&nbsp;&nbsp;Efficacy and safety were evaluated. The primary efficacy outcome was the difference in achieved clinic SBP between the two study groups from months 4 through 12. The safety outcomes comprised hyperkalemia, a composite outcome of falls or syncope, and onset of a need for dialysis or kidney transplantation.&nbsp;The mean clinic SBP at month 12 was 124.7 mm Hg in the intensive SBP goal group and 138.2 mm Hg in the less intensive SBP goal group. The achieved mean clinic SBP in the intensive goal arm was 11.7 mm Hg (95% CI, 7.5-16; P&lt;.001) lower than that achieved in the less intensive goal group on average over months 4 through 12. There was no statistically significant difference in safety outcomes between the two groups (all P&gt;.05).&nbsp;The study found that a clinic SBP goal of less than 120 mm Hg can be safely achieved through real-time home BP monitoring in the study population. However, the sample size was small, so larger trials are needed to determine optimal BP targets for patients with advanced CKD and to assess the risks and benefits associated with more intensive BP control.&nbsp;Source: <a href="https://doi.org/10.1053/j.ajkd.2024.08.010" target="_blank" rel="noopener">American Journal of Kidney Diseases</a>

Sara Nunnery, MD, MSCI

Reclassifying HER2: What Oncologists Need to Know About HER2-Low and -Ultralow Breast Cancer

HER2 Breast Cancer

Jeffrey Perl, MD

Joel M. Topf, MD, FACP

Thoughts From the 2025 Lazarus Award Winner

NKF Spring Clinical Meetings 2025

Brandon Twyford

DESTINY-Breast09 Demonstrates First-Line Superiority of Enhertu Plus Pertuzumab in HER2-Positive Metastatic Breast Cancer

Latest News

Intensive Home Blood Pressure Lowering in Advanced CKD

Chronic Kidney Disease

A trial examined whether lower home systolic blood pressure targets can be met in patients with chronic kidney disease through antihypertensive medications and home BP monitoring.

Intensive Home Blood Pressure Lowering in Advanced CKD 

About Us

Editorial Policy

Advertising

Contact Us

eNewsletters

Contribute

Career Center

MashupMD

Blood Cancers Today

Cancer Nursing Today

GU Oncology Now

Urban Health Today

Bile Duct Cancer

Colorectal Cancer

Gastroesophageal Cancer

Gastric Cancer

GEP-NETs

GIST

Liver Cancer

Pancreatic Cancer

GI Oncology Now

Anemia

Deep Vein Thrombosis

Essential Thrombocythemia

Hemophilia

Immune Thrombocytopenic Purpura

Myelodysplastic Syndromes

Myelofibrosis

Myeloproliferative Neoplasms

Polycythemia Vera

Pulmonary Embolism

Sickle Cell Disease

Thrombocytopenia

Thrombophilia

Thrombosis

Thrombotic Thrombocytopenic Purpura

Venous Thromboembolism

von Willebrand Disease

Heme Today

Acute Kidney Injury

ADPKD

Anemia and Kidney Disease

COVID-19 and Kidney Disease

Diabetes and Hypertension

End-Stage Renal Disease

Gout

Hyperkalemia

IgAN

Kidney Transplantation

Metabolic Acidosis

Nephrology Times

HR Breast Cancer

Triple-Negative Breast Cancer

Genetics & Breast Cancer

Breast Cancers Today

Atherosclerotic Disease

Atrial Fibrillation

Heart Failure

Hypertension

Interventional Cardiology

Lipid Management

Practice Tips With Dr. Lichaa

Preventive Cardiology

Stroke

Cardiology

Breast Cancer

Gynecologic Cancer

Head and Neck Cancer

Skin Cancer

Oncology

Sleep

Urology

Diabetes

Ophthalmology

— Demodex Blepharitis

Neurology

Rheumatology

Gastroenterology

Pulmonology

Infectious Diseases

— HIV

Health and Wellness

Lupus

Future of Medicine

Orthopedics

Pharmacology

Career News

More

Conferences

CardioNerds

The Sleep Source With Dr. Morse

Rheumatology Rounds With Dr. Maheswaranathan

Partners

Expert Interviews

Subscribe