XXXX management in chronic kidney disease: translating guidelines into daily practice.

@entity1 @entity644 @entity8 @entity101 @entity6 @entity551
BACKGROUND: Whether nephrology management improves over time achievement of blood pressure (BP) goal (<130/<80 mm Hg) in nondialysis CKD is still ill-defined. This historical cohort analysis evaluated the relationship between 1-year nephrology management and BP control in 275 incident CKD @entity1 in an @entity8 . METHODS: Comparative analysis between referral and month-12 visit. RESULTS: Estimated glomerular filtration rate (GFR) was 42.1    15.5 ml/min per 1.73 m2 and median @entity644 0.20 g/24 hours. From baseline to month-12 visit, BP decreased from 148    23 / 81    12 mm Hg to 136    18 / 76    11 mm Hg, with BP goal prevalence increasing from 13.8% to 33.8%. We stratified @entity1 into at-goal and not-at-goal on the basis of month-12 BP levels. Regression analysis identified @entity6 (odds ratio [OR] = 1.96; 95% confidence interval [95% CI], 1.07-3.56) and basal systolic BP (OR=1.12; 95% CI, 1.03-1.21) as independent predictors of not-at-goal BP. The decrease in systolic/diastolic BP was smaller in not-at-goal versus at-goal @entity1 (-7/3 mm Hg vs. -21/9 mm Hg); in not-at-goal reduction was, however, significant versus baseline (p<0.001) and coupled with a similar decline in @entity644 (p<0.001). CONCLUSIONS: Sustained nephrology management improves @entity101 control in CKD, but achievement of @entity551 remains suboptimal, with high systolic BP and @entity6 being the main problems. Further studies are needed to verify the clinical significance of BP and @entity644 changes in @entity1 whose BP remains above target levels.
