Association Of Blood Pressure with the Start of Renal Replacement Therapy in Elderly Compared with Young Patients Receiving Predialysis Care

M. C. de Goeij*, D. J. de Jager, D.C. Grootendorst, N. Voormolen, Y. W. Sijpkens, S. van Dijk, E.K. Hoogeveen, J.P. Kooman, E.W. Boeschoten, F.W. Dekker, N. Halbesma

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


BackgroundIn the growing elderly predialysis population, little is known about the effect of identified risk factors on the progression to end-stage renal disease. Therefore, we investigated the association of systolic (SBP) and diastolic blood pressure (DBP) with the start of renal replacement therapy (RRT), in elderly (>/=65 years) compared with young (<65 years) predialysis patients.MethodsIn the PREPARE-1 cohort, 547 incident predialysis patients, referred as part of the usual care to eight Dutch predialysis care outpatient clinics, were included (1999-2001) and followed until the start of dialysis, transplantation, death, or until 1 January 2008. The outcome was the start of RRT. All analyses were stratified for age; <65 years (young) and >/=65 years (elderly).ResultsIn young predialysis patients (n = 268) higher SBP (every 20 mm Hg increase) and high DBP (DBP >/=100 mm Hg compared with 80-89 mm Hg) were associated with a higher rate of starting RRT (adjusted hazard ratio (HR) (95% confidence interval) 1.21 (1.09;1.34) and 1.74 (1.16;2.62), respectively). However, in elderly predialysis patients (n = 240) only patients with SBP >/=180 mm Hg had an increased rate compared with patients with 140-159 mm Hg (adjusted HR 2.33 (1.41;3.87)). Furthermore, patients with DBP <70 or >/=100 mm Hg had an increased rate of starting RRT, independent of SBP, compared with patients with 80-89 mm Hg (fully adjusted HR 1.72 (1.01;2.94) and 2.05 (1.13;3.73), respectively).ConclusionsThe association of SBP and DBP with the start of RRT is different between elderly and young predialysis patients.American Journal of Hypertension 2012; doi:10.1038/ajh.2012.100.
Original languageEnglish
Pages (from-to)1175-1181
JournalAmerican Journal of Hypertension
Issue number11
Publication statusPublished - 1 Jan 2012

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