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Standard goal may not be low enough for those with protein in their urine, study finds, Aggressive treatment to lower high blood pressure may help protect kidney function and prevent the need for dialysis in some black patients with chronic kidney disease.
That's the decision of a study published Sept. 2 in the New England Journal of Medicine.
"This is not a solution. We have a lot more to figure out. But our proof suggests that we have a way to at least delay or possibly even prevent end-stage kidney disease in some patients," study leader Dr. Lawrence J. Appel, a professor of medicine at Johns Hopkins University School of Medicine, said in a Hopkins news release.
The study of 1,094 black patients with chronic kidney disease and high blood pressure found that forceful treatment to lower high blood pressure to about 130/80 provided the most benefit to sicker kidney disease patients those with protein in their urine.
In this group of patients, there was about a 25 percent decrease in end-stage kidney disease compared to those who achieved a blood pressure goal of 140/90, which is the standard of doctors when treating patients with high blood pressure.
Among patients who weren't as sick those with little or no protein in their urine efforts to lower blood pressure had little effect on kidney disease succession.
Appel said, "This has always been a hot topic: Is a lower blood pressure target better at preserving kidney function than the standard goal? The answer is a trained yes, notably in people who have some protein in their urine".
The results suggest that doctors should check for protein in the urine before they decide the blood pressure goal for blacks with kidney disease, he added.