Kidney Week

Abstract: FR-PO1087

Blood Pressure, eGFR, and Kidney Mortality in Mexico: A Prospective Study of 150,000 Adults

Session Information

• CKD: Epidemiology, Risk Factors, and Prevention - 2
  October 25, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 2301 CKD (Non-Dialysis): Epidemiology, Risk Factors, and Prevention

Authors

• Zhu, Doreen, University of Oxford Nuffield Department of Population Health, Oxford, United Kingdom

Doreen Zhu, MD, MBChB

• Kuri-Morales, Pablo Antonio, Universidad Nacional Autonoma de Mexico Facultad de Medicina, Ciudad de Mexico, Ciudad de México, Mexico

Pablo Antonio Kuri-Morales, MSc, MPH

• Wade, Rachel, University of Oxford Nuffield Department of Population Health, Oxford, United Kingdom

Rachel Wade, MSc

• Staplin, Natalie, University of Oxford Nuffield Department of Population Health, Oxford, United Kingdom

Natalie Staplin, PhD

• Garcilazo-Avila,, Adrian, Universidad Nacional Autonoma de Mexico Facultad de Medicina, Ciudad de Mexico, Ciudad de México, Mexico

Adrian Garcilazo-Avila,, MD, MHS, PhD

• Gonzalez-Carballo, Carlos Luis, Universidad Nacional Autonoma de Mexico Facultad de Medicina, Ciudad de Mexico, Ciudad de México, Mexico

Carlos Luis Gonzalez-Carballo, MSc

• Aguilar-Ramirez, Diego J., University of Oxford Nuffield Department of Population Health, Oxford, United Kingdom

Diego J. Aguilar-Ramirez, MD, MSc, PhD

• Bragg, Fiona, University of Oxford Nuffield Department of Population Health, Oxford, United Kingdom

Fiona Bragg, MBChB, MSc, PhD

• Friedrichs, Louisa Gnatiuc, University of Oxford Nuffield Department of Population Health, Oxford, United Kingdom

Louisa Gnatiuc Friedrichs

• Herrington, William G., University of Oxford Nuffield Department of Population Health, Oxford, United Kingdom

William G. Herrington, MD, MA, MBBS

• Holland, Lisa Evelyn, University of Oxford Nuffield Department of Population Health, Oxford, United Kingdom

Lisa Evelyn Holland, PhD

• Hill, Michael R., University of Oxford Nuffield Department of Population Health, Oxford, United Kingdom

Michael R. Hill, PhD

• Torres, Jason Matthew, University of Oxford Nuffield Department of Population Health, Oxford, United Kingdom

Jason Matthew Torres, PhD

• Turner, Michael P., University of Oxford Nuffield Department of Population Health, Oxford, United Kingdom

Michael P. Turner, MBChB, PhD, MPH

• Trichia, Eirini, University of Oxford Nuffield Department of Population Health, Oxford, United Kingdom

Eirini Trichia, MSc, PhD

• Baigent, Colin, University of Oxford Nuffield Department of Population Health, Oxford, United Kingdom

Colin Baigent, MBBS

• Peto, Richard, University of Oxford Nuffield Department of Population Health, Oxford, United Kingdom

Richard Peto, MSc

• Berumen, Jaime, Universidad Nacional Autonoma de Mexico Facultad de Medicina, Ciudad de Mexico, Ciudad de México, Mexico

Jaime Berumen, MD, PhD

• Emberson, Jonathan, University of Oxford Nuffield Department of Population Health, Oxford, United Kingdom

Jonathan Emberson, PhD

• Haynes, Richard, University of Oxford Nuffield Department of Population Health, Oxford, United Kingdom

Richard Haynes, MBChB

• Tapia-Conyer, Roberto, Universidad Nacional Autonoma de Mexico Facultad de Medicina, Ciudad de Mexico, Ciudad de México, Mexico

Roberto Tapia-Conyer

• Alegre-Diaz, Jesus Alegre, Universidad Nacional Autonoma de Mexico Facultad de Medicina, Ciudad de Mexico, Ciudad de México, Mexico

Jesus Alegre Alegre-Diaz, MSc

Group or Team Name

• Mexico City Prospective Study Group.

Background

Chronic kidney disease (CKD) is a leading cause of death and disability in Mexico and blood pressure (BP) may be an important contributor.

Methods

From 1998-2004, 150,000 adults aged ≥35 years from Mexico City were recruited into a blood-based prospective study and followed for cause-specific mortality. A resurvey of 10,000 survivors including urine samples was conducted in 2015-2019. Cox regression related usual BP to risk of death from kidney failure (renal death), excluding those with prior disease (other than diabetes) and adjusted for confounders. Logistic regression related baseline BP to baseline CKD (self-reported and/or eGFR <60 ml/min/1.73m²) and resurvey BP to resurvey albuminuria (<3, 3-30 and ≥30 mg/mmol).

Results

Systolic BP (SBP) was continuously log-linearly related to renal death risk before age 85 years, with each 20 mmHg lower usual SBP associated with 28% lower risk (RR 0.72, 0.68-0.76) (Fig 1). The association was stronger in those without (RR 0.55, 0.50-0.60) than with diabetes (RR 0.81, 0.76-0.87), but the absolute relevance of SBP to risk was larger in those with diabetes. Overall, the excess renal death risk associated with hypertension (self-reported, treated or measured BP ≥140/90 mmHg) accounted for 27% of all renal deaths. 2% of participants had CKD at baseline and 25% of participants who provided a resurvey urine sample had albuminuria. At baseline, 20 mmHg lower SBP was related to a 31% lower odds of CKD (OR 0.69, 0.66-0.72), while at resurvey 20 mmHg lower SBP was related to a 42% lower odds of albuminuria (OR 0.58, 0.53-0.63).

Conclusion

In this study of Mexican adults, BP was strongly related to the risk of renal death and CKD.