Renal Outcome After an Acute GFR Decline in Response to Antihypertensive Treatment

Intensification of antihypertensive treatment sometimes results in a substantial decrease in the estimated glomerular filtration rate (eGFR). Although this change often is attributed to reversible hemodynamic effects, an important issue is whether it predicts adverse renal outcomes. To address this question, researchers pooled individual patient-level data from four major randomized trials in which intensive and standard antihypertensive treatment strategies were compared.^*

Among 4500 patients with eGFR <60 mL/minute/1.73 m² on trial entry, end-stage renal disease developed in 8% during median follow-up of ≈2 years. In adjusted analyses, both standard-treatment patients and intensive-treatment patients whose eGFRs had decreased by >15% at 4 …