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논문분류	춘계학술대회 초록집
제목	Blood pressure control in elderly dialysis patients; a prospective nation-wide ESRD cohort study.
저자	Yong Chul Kim1, Young Lee Jung2, Jung Nam An2, Sohee Oh3, Yoon Kyu Oh2, Chun Soo Lim2, Yong Lim Kim4, Yon Su Kim1, Jung Pyo Lee2
출판정보	2018; 2018(1):
키워드	blood pressure control \| end stage renal disease \| mortality \| elderly patients
초록	Objectives: The appropriate target for BP in patients with CKD and hypertension remains uncertain. Hypertension is the most important treatable risk factor for cardiovascular outcomes. Many patients with CKD are elderly, but the ideal BP in these individuals is unknown. Methods: .Among 5,223 patients on dialysis from the Clinical Research Center for End-Stage Renal Disease cohort from 2008 to 2015, we examined the association of systolic blood pressure (SBP) with all-cause mortality in prevalent and incident dialysis patients. Results: . During 26.5 ± 19.0 months of follow-up, the mean SBP and DBP of study participants were 139.7 ± 22.2 mmHg and 78.2 ± 16 mmHg, respectively. In univariate analysis, SBP showed a U-shape association with all-cause mortality in the entire cohort patients as well as in elderly patients over 65 years. After adjusting confounders such as gender, DM, type of dialysis (hemodialysis, peritoneal dialysis) and body mass index, the hazard ratios (HR) and 95% confidence intervals (CI) associated with SBP < 100 mmHg, 100-120 mmHg, and > 160 mmHg (compared with 120-130 mmHg) in elderly patients were 2.83 (1.45-5.52), 1.62 (1.09-2.41) and 1.59 (1.04-2.42). The risk of all-cause death with SBP over 160 mmHg (compared with 120-130 mmHg) didn’t showed consistent association in those aged below 65 years (HR: 1.10, 95% CI 0.70-1.72), although compared with below 65. Conclusions: .The association of SBP with all-cause death showed U-shape in Korean nation-wide ESRD cohort, especially in elderly patients over 65 years, although adverse outcomes in higher SBP was markedly reduced in patients below 65 years. Strict BP control could be recommended in elderly dialysis patients. Further research is needed to provide a practical BP target for ESRD patients.
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