• Letian Yang, Jian Li, Wei Wei, Yajun Pu, Ling Zhang, Tianlei Cui, Liang Ma, Bo Wang, Yuliang Zhao, and Ping Fu.
• Division of Nephrology, Kidney Research Institute, West China Hospital of Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, China.
• J Gen Intern Med. 2023 Apr 1; 38 (5): 127212811272-1281.

BackgroundBlood pressure variability (BPV) is a risk factor for poor prognosis including cardiovascular events, chronic kidney disease, and mortality, independent of elevated BP.MethodsWe searched PubMed/Medline, EMBASE, and the Cochrane Central Register of Controlled Trials (CENTRAL) from inception to November 23, 2022. Cohort studies reporting the association between BPV and chronic kidney disease (CKD) progression were selected. Hazard ratios were pooled using a random-effects model. Meta-regression, subgroup analyses, and sensitivity analyses were conducted.ResultsA total of 23 studies were included in this systematic review and meta-analysis. Increased BPV was associated with progression of CKD (HR: 1.21, 95% CI: 1.09-1.33) and incidence of ESRD (HR: 1.08, 95% CI: 1.08-1.30). Among the different BPV metrics, high variation independent of mean (VIM), coefficient of variation (CV), standard deviation (SD), and average real variability (ARV) were indicated as predictors of CKD progression.DiscussionIncreased BPV was associated with CKD progression.© 2023. The Author(s), under exclusive licence to Society of General Internal Medicine.

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