Supplementary Material for: Effect of Orthostatic Hypotension on Kidney Function

<b><i>Background:</i></b> The association between orthostatic hypotension (OH) and long-term changes in kidney function in the general population is not yet well known. <b><i>Methods:</i></b> We performed a population-based cohort study based on data from the Korean Genome and Epidemiology Study (KoGES). The primary exposure was the presence of classic OH, defined as a postural drop in blood pressure (systolic blood pressure ≥20 mm Hg and/or diastolic blood pressure ≥10 mm Hg) at 2 min of standing after 5 min of supine rest. The primary outcome was a 12-year change in kidney function, assessed by subtracting the baseline estimated glomerular filtration rate (eGFR) from the eGFR at 12 years of follow-up. <b><i>Results:</i></b> Our study included 5,905 participants (median [interquartile range] age, 49 [44–58] years; 46% males) who met inclusion and exclusion criteria. Classic OH was detected in 268 (4.5%) of the total participants. In the regression analyses, participants with classic OH had a greater decline in eGFR over 12 years compared with those without classic OH; the fully adjusted beta coefficient and 95% confidence intervals (95% CIs) were −1.74 (−3.07, −0.40). Furthermore, classic OH was associated with 27% greater risk of a 30% decline in kidney function compared with those without classic OH; fully adjusted hazard ratio and 95% CIs were 1.27 (1.07, 1.49). <b><i>Conclusions:</i></b> Classic OH can negatively affect long-term kidney function in the general population.

**背景**：普通人群中体位性低血压（orthostatic hypotension, OH）与肾功能长期变化之间的关联目前尚未完全明确。
**方法**：本研究基于韩国基因组与流行病学研究（Korean Genome and Epidemiology Study, KoGES）的数据开展了一项基于人群的队列研究。本研究的主要暴露因素为经典型体位性低血压，定义为仰卧休息5分钟后站立2分钟时出现的血压下降（收缩压≥20毫米汞柱且/或舒张压≥10毫米汞柱）。本研究的主要结局为肾功能的12年变化，通过随访12年时的估算肾小球滤过率（estimated glomerular filtration rate, eGFR）减去基线估算肾小球滤过率进行评估。
**结果**：本研究共纳入符合纳入排除标准的5905名研究对象，年龄中位数（四分位数间距）为49岁（44~58岁），男性占比46%。总计268名研究对象存在经典型体位性低血压，占总人群的4.5%。回归分析结果显示，与无经典型体位性低血压的研究对象相比，存在经典型体位性低血压的研究对象在12年间的eGFR下降幅度更大；完全校正后的β系数与95%置信区间（95% CIs）为-1.74（-3.07，-0.40）。此外，与无经典型体位性低血压的研究对象相比，存在经典型体位性低血压者的肾功能下降30%的风险升高27%；完全校正后的风险比与95% CIs为1.27（1.07，1.49）。
**结论**：经典型体位性低血压可对普通人群的长期肾功能产生负面影响。