Acknowledging the impact of seasonal blood pressure variation in hypertensive CKD and non-CKD patients living in a Mediterranean climate.

BackgroundThis study aims to assess seasonal blood pressure (BP) variation in chronic kidney disease (CKD) and non-CKD patients living in a Mediterranean climate, and to find out if this variation entails significant adjustment of treatment and if it impacts renal outcomes and mortality.MethodsThis retrospective study included all hypertensive patients seen between February 2006 and April 2020 in two Lebanese clinics. Regression analyses were used to assess the association of seasonal BP variability and treatment adjustment with eGFR change from baseline, dialysis initiation and death.ResultsA total of 398 patients of 64.2 ±13.9 years were followed for 51.1 ±44.3 months, 67% had eGFRConclusionThis study confirmed the seasonal BP variability in CKD and non-CKD patients from a Mediterranean climate. All types of treatment adjustment were associated with eGFR loss. Low BP in the warm season was highly associated with death

Association of renal resistive indices with kidney disease progression and mortality

Abstract Background Renal resistive indices (RRI) have been shown to predict the progression of kidney disease. This study aims to evaluate the association of RRI with mortality and dialysis initiation after adjustment to therapeutic and life style interventions. Methods This is a retrospective study that included all chronic kidney disease patients followed for at least two years in three nephrology clinics between 2006 and 2019 and who had a RRI level in their files. Kaplan Meier and log rank test compared the survival of patients with normal versus high RRI. Cox regression analysis evaluated the association between RRI and death or dialysis initiation after adjustment to treatments and life style modifications. Results A total of 192 patients were analyzed: 68 had RRI < 0.7 and 124 had RRI ≥ 0.7. Their mean age was 66.5 ± 13.1 years at first visit, 78.1% were males. There was a negative correlation between baseline eGFR and RRI (p < 0.001; Spearman correlation coefficient = -0.521). The survival was significantly better in patients with RRI < 0.7 with a Log Rank test < 0.001. The univariate cox regression analysis showed a significant association between RRI and mortality (HR = 1.08; 95%CI: 1.04–1.11; p < 0.001) that remained significant after adjustment to cardiovascular risk factors and interventions such as salt reduction, blood pressure control, statins and RAAS inhibitors (HR = 1.04; 95%CI: 1.00–1.08; p = 0.036). Cox regression analysis showed a significant association between RRI and dialysis initiation (HR = 1.06; 95%CI 1.01–1.10; p = 0.011). Conclusion Our study revealed that patients with an elevated RRI ≥ 0.7 are at a higher risk of mortality after adjustment to medications and lifestyle modifications. RRI can, according to this study, be considered as an independent prognostic factor in CKD patients