Are the Kidneys Harmed by Intensive Blood Pressure Lowering?

The Systolic Blood Pressure Intervention Trial (SPRINT) showed that patients at moderate cardiovascular risk who received more-intensive systolic blood pressure (SBP) treatment (target SBP, <120 mm Hg) had lower mortality (1.2% absolute difference at 3 years) than did patients who received less-intensive treatment (target SBP, <140 mm Hg). However, the incidence of new chronic kidney disease (CKD; i.e., ≥30% reduction in estimated glomerular filtration rate [eGFR] to <60 mL/minute/1.73 m²) was higher among intensively treated patients than among conservatively treated patients (NEJM JW Gen Med Dec 15 2015 and N Engl J Med 2015; 373:2174). In a new analysis, researchers used a nested case-control design to evaluate urinary biomarkers of kidn…