Impact of chronic kidney disease and blood pressure goal on cardiovascular mortality in diabetes

T most common cause of end-stage kidney disease (ESKD) requiring dialysis in the world results from poorly controlled diabetes in genetically prone individuals. About 30-35% of all people with either Type 1 or Type 2 diabetes will develop chronic kidney disease advancing to Stage 5d or ESKD. Such individuals are known to be at much higher risk of dying from cardiovascular disease. While the concept of diabetes being of equivalent risk to myocardial infarction for dying has been disproven, individuals with chronic kidney disease (CKD) Stages 3 (eGFR<60 ml/min) or higher stage have a higher risk for all-cause mortality compared to those with diabetes without CKD or previous myocardial infarction. Moreover, lowering blood pressure to levels well below 130/80 mmHg has not been shown to further reduce cardiovascular mortality based on both prospective and retrospective trial analyses. Hence, Prevention of CKD and less aggressive blood pressure control are the order of the day. George Bakris, J Diabetes Metab 2013, 4:6 http://dx.doi.org/10.4172/2155-6156.S1.024