P0759ORTHOSTATIC SYSTOLIC BLOOD PRESSURE CHANGE AND THE RISK OF CHRONIC KIDNEY DISEASE: A COMMUNITY-BASED PROSPECTIVE STUDY IN KOREA

Abstract

Abstract Background and Aims There have been no studies which explored the relationship between orthostatic blood pressure (BP) change and incident chronic kidney disease (CKD) in Asian population. Method We reviewed the data of 7,461 non-CKD adults aged 40-69 years who participated in Ansung_Ansan Cohort, a prospective community-based cohort study. BP was measured on supine position and 2 minute–upright position, and the difference was defined as orthostatic BP change. Incident CKD was defined as the first event to be estimated glomerular filtration rate < 60 ml/min/1.73 m2, which was confirmed at least 2 or more times thereafter. Results Of 7,461, orthostatic diastolic BP change was not associated with incident CKD in multivariate Cox proportional-hazard regression model. However, per 1 mmHg increase of orthostatic systolic BP was associated with decreased hazard of incident CKD: hazard ratio 0.988 and 95% confidence interval (0.982-0.994, P <0.001). In penalized spline curve analysis, we identified L-shaped relationship between orthostatic systolic BP change and incident CKD, with the threshold of - 2.4 mmHg. In subgroup analysis, the relationship between orthostatic systolic BP change and incident CKD was evident, particularly in participants without central obesity and reduced high density lipoprotein cholesterol and those with increased white blood cells. Conclusion Orthostatic SBP change was independently associated with incident CKD development. Future studies need to be followed to confirm the results.