Kidney Res Clin Pract.  2021 Sep;40(3):432-444. 10.23876/j.krcp.21.245.

Blood pressure prior to percutaneous coronary intervention is associated with the risk of end-stage renal disease: a nationwide population based-cohort study

• Bae EH
• Lim SY
• Kim B
• Han KD
• Oh TR
• Choi HS
• Kim CS
• Ma SK
• Kim SW

• KMID: 2524389
• DOI: http://doi.org/10.23876/j.krcp.21.245

Abstract

Background
Hypertension is the most important modifiable risk factor for mortality and morbidity in chronic kidney disease and coronary artery syndrome. The effect of hypertension prior to percutaneous coronary intervention (PCI) on the development of end-stage renal disease (ESRD) is unknown.
Methods
We used nationally representative data from the Korean National Health Insurance System—140,164 subjects were enrolled during 2010–2015; they were free of ESRD at enrolment, underwent PCI, and were followed up until 2017. Blood pressure (BP) was measured within at least 2 years prior to PCI. The primary outcome was the development of ESRD.
Results
During a median follow-up of 5.4 years, 2,082 participants (1.5%) developed ESRD. The highest systolic BP group (>160 mmHg) showed a higher hazard ratio (3.69; 95% confidence interval, 2.61–5.23) than the reference group (110–119 mmHg). Similar results were observed in the highest diastolic BP group (>120 mmHg), which showed a higher hazard ratio than the reference group (70–79 mmHg). However, ESRD risk showed a J-shaped relationship with baseline systolic and diastolic BP at 113 and 74 mmHg in diabetes mellitus subgroup, respectively, after adjustment for potential confounders.
Conclusion
Our study showed that a high systolic or diastolic BP prior to PCI was independently associated with an increased incidence of ESRD.

Keyword

End-stage renal disease; Hypertension; Korean; Percutaneous coronary intervention; Risk