New study: lowering blood pressure saves lives in dialysis patients

For the first time, Australian researchers at The George Institute have identified that blood pressure lowering treatment significantly reduces the risk of death for dialysis patients, as published online today in the Lancet.

Dialysis treatment replaces lost kidney function for people with kidney failure. Kidney disease affects 2 million Australians, 10,000 of whom must undertake regular dialysis and have a one in eight chance of death each year, as well as a greatly increased risk of cardiovascular disease. Until now, no treatments had been clearly proven to reduce this increased risk.

According to author, Dr Vlado Perkovic at The George Institute in Sydney, "Our systematic review assessed the effect of blood pressure lowering in patients on dialysis. We found that blood pressure lowering significantly reduces the high death rate in patients on dialysis, preventing one in five deaths compared to people who did not receive the treatment. Patients on dialysis are at a greatly elevated risk of death, compared to the general population."

"These results will change the way clinicians treat dialysis patients," added Dr Perkovic. "Our study shows blood pressure lowering treatment should routinely be considered for individuals undergoing dialysis to protect patients from the high rate of cardiovascular disease such as heart attack and stroke, and to reduce their risk of dying. The benefits of this treatment are very large, particularly as they appear similar across all groups of dialysis patients, including those with either normal or high blood pressure levels."

This study was funded as part of a program grant to The George Institute from Australia’s National Health and Medical Research Council (NHMRC), CEO of the Council, Professor Warwick Anderson congratulated The George Institute on the new research.

The Medical Director of Kidney Health Australia, Dr Tim Mathew said: "This review adds a new dimension of certainty to blood pressure management of dialysis patients. There is no longer room for equivocation - blood pressure lowering should stay at the forefront of cardiovascular risk reduction in this very high risk group whose mortality rate at about 10% per year remains a major challenge. With the full clinical uptake of the conclusions in this review, Australia could expect to see improvement in this mortality rate in coming years."

Researchers conducted a systematic review and meta-analysis of among relevant trials to clarify previous uncertainty around blood pressure lowering in dialysis patients. Over 1600 dialysis patients were assessed on the effects of blood pressure lowering.