[Influence of blood pressure on the progression rate of advanced chronic renal insufficiency].

Influence of systemic arterial pressure on the progression rate of renal function in patients with advanced CRF is still controversial. In a retrospective analysis of 167 patients with well-characterized primitive nephropathy, we analyzed the influence of mean arterial pressure (MAP), either treated or untreated, on the progression rate of CRF as judged by the time interval elapsed between plasma creatinine 500 mumol/l and first iterative hemodialysis (500-HD). In the whole group, mean 500-HD interval was 15.5 +/- 10.5 months (mean +/- SD). Linear regression analysis showed a weak correlation between MAP and 500-HD (r = -0.20; p less than 0.02). Significant correlation could not be found in subgroup analysis of patients with chronic glomerulonephritis (n = 68), angionephrosclerosis (n = 22), or polycystic kidney disease (n = 35). A significant negative correlation between MAP and 500-HD was demonstrated in the subgroup of 42 patients with chronic interstitial nephritis (r = -0.47; p less than 0.002). Stratification analysis according to MAP values did not reveal significant differences in 500-HD interval except for the patients with MAP less than or equal to 95 mmHg whose 500-HD was 24.7 +/- 18.4 months versus 14.7 +/- 9.0 months in patients with MAP greater than 95 mmHg (p less than 0.001). These results suggest that MAP may not be a determinant factor in the progression rate of advanced CRF, except possibly for patients with chronic interstitial nephritis and/or very low MAP.