Among people with hypertension who are at high risk for cardiovascular disease (CVD), greater estimated glomerular filtration rate (eGFR) variability is independently associated with all-cause mortality, according to a study published in the American Journal of Kidney Diseases. Researchers examined the association between variability in eGFR and the risk for CVD events and all-cause mortality using data from 7,520 participants (mean age, 68, and with one or more CVD risk factors) in the Systolic Blood Pressure Intervention Trial. Overall, the mean eGFR was 73 mL/min/1.73 m2 at 6 months, and there were 370 CVD events and 154 deaths during a median followup of 2.4 years. There was an association noted between greater eGFR variability and higher risk for all-cause mortality (hazard ratio [HR] per standard deviation greater variability, 1.29; 95% confidence interval [CI], 1.14 to 1.45) but not CVD events (HR, 1.05; 95% CI, 0.95 to 1.16) when adjusting for albuminuria at baseline, eGFR at month 18, and other CVD risk factors. Results were similar when examined by treatment arm and baseline CKD status and when accounting for concurrent systolic blood pressure changes, use of angiotensinconverting enzyme inhibitors or angiotensin receptor blockers, and diuretic medications during follow-up.
