BP Control in CKD: Risks, Preferences, and Intensive Management
- New analysis of the SPRINT trial data suggests intensive blood pressure control (
- A recent analysis of the Systolic Blood Pressure Intervention Trial (SPRINT) indicates that a systolic blood pressure target of less than 120 mm Hg, compared to less than...
- The study involved a benefit-harm trade-off analysis of 2,012 participants with CKD from the original SPRINT trial.Researchers focused on predicting individualized treatment effects for multiple outcomes, including cardiovascular...
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Individualized Blood Pressure Targets show Benefit for Chronic Kidney Disease
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New analysis of the SPRINT trial data suggests intensive blood pressure control (<120 mmHg) offers net benefits for most adults with chronic kidney disease (CKD).
key Findings from the SPRINT Trial Analysis
A recent analysis of the Systolic Blood Pressure Intervention Trial (SPRINT) indicates that a systolic blood pressure target of less than 120 mm Hg, compared to less than 140 mm Hg, would likely provide net health benefits for the vast majority of adults living with chronic kidney disease (CKD). These findings were presented at ASN Kidney Week 2025, held November 5-9.
The study involved a benefit-harm trade-off analysis of 2,012 participants with CKD from the original SPRINT trial.Researchers focused on predicting individualized treatment effects for multiple outcomes, including cardiovascular events, kidney failure, and mortality.
Understanding the SPRINT Trial and CKD
The SPRINT (Systolic Blood Pressure Intervention Trial) was a landmark study investigating the impact of intensive versus standard blood pressure control on cardiovascular outcomes. originally published in 2015,SPRINT demonstrated that lowering systolic blood pressure to below 120 mm Hg reduced the risk of cardiovascular events and death in a general population of adults at high risk for cardiovascular disease. However, the optimal blood pressure target for individuals with CKD remained less clear.
Chronic Kidney Disease (CKD) is a condition characterized by a gradual loss of kidney function over time. According to the Centers for Disease Control and Prevention (CDC), approximately 37 million adults in the United States have CKD.CKD considerably increases the risk of cardiovascular disease, making blood pressure management notably crucial for this population.
Individualized Benefit-Harm Assessment
This new analysis goes beyond simply comparing average outcomes.It uses predictive modeling to estimate the individualized net benefit of intensive blood pressure control for each participant. This approach acknowledges that the optimal blood pressure target may vary depending on a patient’s specific risk factors and characteristics.
Investigators found that, for the vast majority of CKD patients in the study, the benefits of lowering systolic blood pressure to below 120 mm Hg outweighed the potential harms. This suggests that current guidelines recommending a less stringent blood pressure target of below 140 mm Hg may be too lenient for many individuals with CKD.
Implications for Clinical Practice
These findings have important implications for the management of CKD. While further research is needed to confirm these results and refine individualized treatment strategies, they suggest that clinicians should consider more aggressively lowering blood pressure in most patients with CKD.
However, it’s crucial to remember that intensive blood pressure control is not without risks. Potential side effects include dizziness, fatigue, and electrolyte imbalances. Thus, careful monitoring and