- Higher levels of interleukin (IL)-6 and tumor necrosis factor-α (TNF-α) are associated with higher odds of apparent treatment-resistant hypertension (ATRH) in chronic kidney disease (CKD).
- Lower levels of transforming growth factor-β (TGF-β) are tied to lower ATRH risk.
Why this matters
- ATRH prevalence in CKD is 40.4% (vs general population, 8.9%).
- Targeting specific inflammatory pathways may improve BP control.
- ATRH risk was elevated with highest vs lowest tertiles of IL-6 (aOR=1.29; 95% CI, 1.05-1.59) and TNF-α (aOR=1.49; 95% CI, 1.20-1.85).
- IL-6: risk/1 standard deviation (SD) increase (0.89 pg/mL: aOR=1.09; P=.05).
- TNF-α: risk/1SD increase (0.69 mg/dL: aOR=1.12; P=.009).
- ATRH risk was lowered with highest vs lowest tertiles of TGF-β (aOR=0.77; 95% CI, 0.63-0.95).
- Risk/1SD increase (0.67 ng/mL: aOR=0.88; P=.004).
- No significant associations with high-sensitivity C-reactive protein, fibrinogen, IL-1β, or IL-1 receptor antagonist.
- ATRH was tied to increased risks for cardiovascular disease (aHR=1.49; P<.001 and all-cause mortality p=".002).</li">
- Chronic Renal Insufficiency Cohort (CRIC) participants with CKD and hypertension (HTN): 1359 with ATRH and 2008 without.
- ATRH: BP ≥140/90 mmHg on ≥3 antihypertensives or
- Funding: National Institute of Diabetes and Digestive and Kidney Diseases, Perelman School of Medicine, Johns Hopkins University, others.
- Observational design.