Blood Pressure, Kidney Function, and Kidney Mortality Among Mexican Adults
In brief
20 mm Hg lower systolic pressure cuts kidney-failure death risk by 24%
In a cohort of 133,000 Mexican adults without prior kidney disease, each 20 mm Hg drop in baseline systolic blood pressure was linked to a 24% lower chance of dying from kidney failure, and the same reduction lowered odds of later chronic kidney disease and albuminuria by about one-quarter. Hypertension accounted for roughly one-tenth of kidney-failure deaths, underscoring blood-pressure control as a key preventive target.
- Journal
- American journal of kidney diseases : the official journal of the National Kidney Foundation (Q1)
- Published
- 13 August 2026
- Study design
- Prospective / inception cohort
- Evidence level
- Level 2, Moderate (CEBM 2b)
- Authors
- Doreen Zhu, Pablo Kuri-Morales, Rachel Wade, Natalie Staplin, Adrián Garcilazo-Ávila, Carlos González-Carballo, et al.
- PMID
- 42595039
- DOI
- 10.1053/j.ajkd.2026.05.019
Why clinicians should know about it
- Picked for Nephrology (paper of the day, 16 August 2026): BP, CKD, kidney mortality in Mexican adults
Abstract
RATIONALE & OBJECTIVE: Chronic kidney disease (CKD) is a major cause of death in Mexico and blood pressure (BP) may be an important contributor. This study investigated the associations of BP with CKD, albuminuria, and death from kidney failure. STUDY DESIGN: Prospective cohort study. SETTING & PARTICIPANTS: 133,470 adults aged ≥35 to <85 years without CKD or other chronic disease (except diabetes), recruited from two districts of Mexico City between 1998 and 2004, and who survived ≥5 years after recruitment. A random subset of 9198 underwent additional evaluation 2015-2019. EXPOSURES: Systolic BP (SBP), diastolic BP (DBP) and hypertension (participant report of taking blood pressure lowering medication or BP ≥140/90 mm Hg). OUTCOMES: Kidney failure mortality during follow-up, and CKD (self-report and/or eGFR <60 mL/min/1.73m2) and albuminuria at the time of repeat clinical evaluation. ANALYTICAL APPROACH: Multivariable Cox regression for the association of BP with kidney failure mortality and multivariable logistic regression for the association of baseline BP with CKD and albuminuria at the time of re-evaluation. RESULTS: Among all participants, SBP showed a continuous "log-linear" association with kidney failure mortality; each 20 mm Hg lower SBP being associated with 24% lower risk at ages 40-84 years (kidney failure death hazard ratio [HR] 0.76, 95% confidence interval 0.69-0.84). The association was stronger among those without diabetes (HR 0.54, 0.45-0.69) than with diabetes (HR 0.90, 0.80-1.01) but the absolute excess risk associated with higher BP was similar in these subgroups. Hypertension accounted for 9% of kidney failure deaths. Among those re-evaluated, 6% had developed CKD and 25% had albuminuria. 20 mm Hg lower baseline SBP was associated with 24% lower odds of both CKD (odds ratio [OR] 0.76, 0.68-0.85) and albuminuria (OR 0.76, 0.68-0.84) at the time of re-evaluation. Results were similar for DBP. LIMITATIONS: Baseline urine samples were unavailable and kidney function trends over time could not be assessed. CONCLUSIONS: This large prospective study in Mexican adults highlights elevated BP as a major modifiable risk factor for kidney failure mortality, CKD, and albuminuria.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.