The results of SPRINT study from the point of nephrology

Czech version

Authors: Václav Monhart ^1,2
Authors‘ workplace: Interní klinika 1. LF UK a Ústřední vojenské nemocnice-Vojenské fakultní nemocnice, Praha ¹; Nefrologická ambulance Synlab Czech, s. r. o., Praha ²
Published in: Vnitř Lék 2016; 62(Suppl 6): 55-57
Category: Reviews

Overview

There is no consensus of the opinion that the value of systolic blood pressure (SBP) is the most favourable for the treatment of hypertension in patients with chronic kidney disease (CKD). The interventional study SPRINT (The Systolic Blood Pressure Intervention Trial) demonstrated the significant reduction in major cardiovascular events and overall mortality with intensive control of SBP (< 120 mm Hg) in individuals with high risk, including those with CKD and mild proteinuria. Nephrologists should take into account the results of the SPRINT study in the determination of the optimal SBP in patients with CKD, but at the same time they pay the attention to the early detection of adverse events related to treatment, including disorders of electrolyte balance, acute renal impairment, hypotension, and side effects of medications.

Key words:
acute kidney injury – cardiovascular events – glomerular filtration rate – chronic kidney disease – proteinuria – systolic blood pressure

Sources

1. Wright JT Jr, Williamson JD, Whelton PK et al. [The SPRINT Research Group]. A randomized trial of intensive versus standard blood-pressure control. N Engl J Med 2015; 373(22): 2103–2116. Dostupné z DOI: <http://dx.doi.org/10.1056/NEJMoa1511939>.

2. Cífková R. Změní výsledky studie SPRINT dosavadní doporučení pro léčbu hypertenze? Hypertenze a kardiovaskulární prevence 2016; 5(1): 15–17.

3. Ambrosius WT, Sink KM, Foy CG et al. The design and rationale of a multicenter clinical trial comparing two strategies for control of systolic blood pressure: the Systolic Blood Pressure Intervention Trial (SPRINT). Clin Trials 2014; 11(5): 532–546. Dostupné z DOI: <http://dx.doi.org/10.1177/1740774514537404>.

4. Souček M. Studie SPRINT. Kam až snižovat krevní tlak. Hypertenze a kardiovaskulární prevence 2016; 5(1): 11–14.

5. [Kidney Disease Improving Global Outcomes (KDIGO) Blood Pressure Work Group]. KDIGO clinical practice guideline for the management of blood pressure in chronic kidney disease. Kidney Int Suppl 2012; 2(5): 337–414.

6. Monhart V. Doporučení KDIGO pro léčbu zvýšeného krevního tlaku u chronického onemocnění ledvin. Vnitř Lék 2013; 59(12): 1096–1106.

7. Monhart V. Komentář k doporučením KDIGO pro léčbu zvýšeného krevního tlaku u nemocných s chronickým onemocněním ledvin 2012. Hypertenze a kardiovaskulární prevence 2013; 2(2): 29–30.

8. James PA, Oparil S, Carter BL et al. 2014 evidence-based guideline for the management of high blood pressure in adults. Report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA 2014; 311(5): 507–520. Dostupné z DOI: <http://dx.doi.org/10.1001/jama.2013.284427>.

9. Rocco MV, Cheung AK. A SPRINT to the Finish, or Just the Beginning? Implications of the SPRINT Results for Nephrologists. Kidney Int 2016; 89(2): 261–263. Dostupné z DOI: <http://dx.doi.org/10.1016/j.kint.2015.12.024>.

10. Filipovský J, Widimský J Jr, Ceral J et al. Diagnostické a léčebné postupy u arteriální hypertenze – verze 2012. Doporučení České společnosti pro hypertenzi. Vnitř Lék 2012; 58(10): 785–801.