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Association Of Blood Pressure with the Start of Renal Replacement Therapy in Elderly Compared with Young Patients Receiving Predialysis Care.
MedLine Citation:
PMID:  22810845     Owner:  NLM     Status:  Publisher    
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.
Moniek C M de Goeij; Dinanda J de Jager; Diana C Grootendorst; Nora Voormolen; Yvo W J Sijpkens; Sandra van Dijk; Ellen K Hoogeveen; Jeroen P Kooman; Elisabeth W Boeschoten; Friedo W Dekker; Nynke Halbesma
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-7-19
Journal Detail:
Title:  American journal of hypertension     Volume:  -     ISSN:  1941-7225     ISO Abbreviation:  -     Publication Date:  2012 Jul 
Date Detail:
Created Date:  2012-7-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8803676     Medline TA:  Am J Hypertens     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.
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