{"doi":"10.34067/kid.0005362021","title":"Pharmacogenomics of Hypertension in CKD: The CKD-PGX Study","abstract":"Key Points The CKD-PGX study assessed the feasibility of pharmacogenomic testing for a panel of antihypertensive agent efficacy predictors. Most patients with uncontrolled hypertension had one or more drug-gene interactions predicting reduced efficacy of their medications. In 36% of cases, practitioners used genetic data to change BP management in their patients with CKD. Background Patients with CKD often have uncontrolled hypertension despite polypharmacy. Pharmacogenomic drug-gene interactions (DGIs) may affect the metabolism or efficacy of antihypertensive agents. We report changes in hypertension control after providing a panel of 11 pharmacogenomic predictors of antihypertensive response. Methods A prospective cohort with CKD and hypertension was followed to assess feasibility of pharmacogenomic testing implementation, self-reported provider utilization, and BP control. The analysis population included 382 subjects with hypertension who were genotyped for cross-sectional assessment of DGIs, and 335 subjects followed for 1 year to assess systolic BP (SBP) and diastolic BP (DBP). Results Most participants (58%) with uncontrolled hypertension had a DGI reducing the efficacy of one or more antihypertensive agents. Subjects with a DGI had 1.85-fold (95% CI, 1.2- to 2.8-fold) higher odds of uncontrolled hypertension, as compared with those without a DGI, adjusted for race, health system (safety-net hospital versus other locations), and advanced CKD (eGFR <30 ml/min). CYP2C9 -reduced metabolism genotypes were associated with losartan response and uncontrolled hypertension (odds ratio [OR], 5.2; 95% CI, 1.9 to 14.7). CYP2D6 -intermediate or -poor metabolizers had less frequent uncontrolled hypertension compared with normal metabolizers taking metoprolol or carvedilol (OR, 0.55; 95% CI, 0.3 to 0.95). In 335 subjects completing 1-year follow-up, SBP (−4.0 mm Hg; 95% CI, 1.6 to 6.5 mm Hg) and DBP (−3.3 mm Hg; 95% CI, 2.0 to 4.6 mm Hg) were improved. No significant difference in SBP or DBP change were found between individuals with and without a DGI. Conclusions There is a potential role for the addition of pharmacogenomic testing to optimize antihypertensive regimens in patients with CKD.","journal":"Kidney360","year":2021,"id":178037,"datarank":0.4566783656585135,"base_score":3.044522437723423,"endowment":3.044522437723423,"self_citation_contribution":0.4566783656585135,"citation_network_contribution":0.0,"self_endowment_contribution":0.4566783656585135,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":20,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9528,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":461849,"name":"Judith Maddatu","orcid":"0000-0003-0119-097X","position":1,"is_corresponding":false},{"id":307588,"name":"Sharon M. Moe","orcid":"0000-0003-3562-9725","position":2,"is_corresponding":false},{"id":336434,"name":"Arjun Sinha","orcid":"0000-0003-4970-1150","position":3,"is_corresponding":false},{"id":388333,"name":"Ricardo Melo Ferreira","orcid":"0000-0003-2063-9744","position":4,"is_corresponding":false},{"id":723128,"name":"Brent W. Miller","orcid":"0000-0002-6289-7138","position":5,"is_corresponding":false},{"id":723774,"name":"S. Jawad Sher","orcid":null,"position":6,"is_corresponding":false},{"id":458975,"name":"Jing Su","orcid":"0000-0003-4917-6173","position":7,"is_corresponding":false},{"id":262351,"name":"Victoria M. Pratt","orcid":"0000-0003-2871-5051","position":8,"is_corresponding":false},{"id":283028,"name":"Arlene B. Chapman","orcid":"0000-0003-4538-4565","position":9,"is_corresponding":false},{"id":454682,"name":"Todd C. Skaar","orcid":"0000-0002-3849-374X","position":10,"is_corresponding":false},{"id":307591,"name":"Ranjani N. Moorthi","orcid":"0000-0002-3125-0868","position":11,"is_corresponding":false},{"id":307583,"name":"Michael T. Eadon","orcid":"0000-0003-3066-2876","position":0,"is_corresponding":true}],"reference_count":49,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-18T23:47:36.112170Z","pmid":"35342886","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}