In 2006, treating end-stage kidney disease cost the federal government $23 billion, and chronic kidney disease cost $49 billion. In the U.S., hypertension causes about 30 percent of end-stage kidney disease. African-Americans make up a disproportionate number of patients with end-stage kidney disease attributed to hypertension.
Observational studies have shown that treating kidney-disease patients to help them achieve lower blood pressure has prevented progression to end-stage kidney disease, but few formal trials have tested the idea. In the limited studies that have, African-Americans were not well-represented.
In the current study, patients ranged in age from 18 to 70, with an average age of 55. Nearly 40 percent of the patients were female. The patients came from 21 centers throughout the United States; 77 patients were treated at UT Southwestern.
To test if a lower blood pressure goal would help African-Americans with chronic kidney disease, AASK researchers broke the study into two phases. From 1995 to 1998, patients were randomly assigned 1,094 to receive either intensive blood pressure treatment to reach levels below 130/80 mm Hg, or standard blood pressure control of 140/90 mm Hg. They were monitored for three and six years.
After completion of the trial, a second phase known as the AASK cohort study included patients who were then switched to the same medication, and all eventually had a blood pressure target of 130/80 mm Hg. Blood pressure levels and hypertension were monitored every two years for patients whose disease had not progressed. Some patients were followed for up to 12 years.
Based on evidence emerging from other studies, AASK researchers also analyzed their data based on how much protein was found in each patient's urine. About one-third of patients had protein in the urine.
Among those patients, the ris
|Contact: LaKisha Ladson|
UT Southwestern Medical Center